Provider Demographics
NPI:1821021734
Name:ARNOLD-HARRIS, SANDRA E (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:ARNOLD-HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-4632
Mailing Address - Country:US
Mailing Address - Phone:540-434-1941
Mailing Address - Fax:540-434-0132
Practice Address - Street 1:1241 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802
Practice Address - Country:US
Practice Address - Phone:540-434-1941
Practice Address - Fax:540-434-0132
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0015000446364SP0809X
VA0024166677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAR98729Medicare UPIN
VA010748S48Medicare PIN
VAC00248Medicare PIN