Provider Demographics
NPI:1710363262
Name:ARNOLD, JENEA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JENEA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JENEA
Other - Middle Name:
Other - Last Name:ANDRUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:11555 SOUTHFORK AVE
Mailing Address - Street 2:APT 3074
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2263
Mailing Address - Country:US
Mailing Address - Phone:225-802-8578
Mailing Address - Fax:
Practice Address - Street 1:11555 SOUTHFORK AVE
Practice Address - Street 2:APT 3074
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2263
Practice Address - Country:US
Practice Address - Phone:225-802-8578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA139469163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse