Provider Demographics
NPI:1790867448
Name:FOLEY, ARLENE F (CFNP)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:F
Last Name:FOLEY
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:YAZOO CITY
Mailing Address - State:MS
Mailing Address - Zip Code:39194
Mailing Address - Country:US
Mailing Address - Phone:662-716-8071
Mailing Address - Fax:662-716-8072
Practice Address - Street 1:2121 GRAND AVE
Practice Address - Street 2:
Practice Address - City:YAZOO CITY
Practice Address - State:MS
Practice Address - Zip Code:39194
Practice Address - Country:US
Practice Address - Phone:662-716-8071
Practice Address - Fax:662-716-8972
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR828512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00126718Medicaid
500002356Medicare PIN
NMNM301472Medicare PIN
MS00126718Medicaid