Provider Demographics
NPI:1659344646
Name:ARNOLD, RICHARD (FNP, BC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MORRISSEY BLVD
Mailing Address - Street 2:UMASS BOSTON HEALTH SERVICES
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3393
Mailing Address - Country:US
Mailing Address - Phone:617-458-1694
Mailing Address - Fax:617-926-9381
Practice Address - Street 1:100 MORRISSEY BLVD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02125-3300
Practice Address - Country:US
Practice Address - Phone:617-458-1694
Practice Address - Fax:617-926-9381
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3454OtherBLUE CROSS
MANP3454OtherBLUE CROSS
MANP345401Medicare PIN
MANP3454Medicare ID - Type Unspecified
MANP345402Medicare PIN