Provider Demographics
NPI:1821848045
Name:ARDEN HEALTH LLC
Entity Type:Organization
Organization Name:ARDEN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DEARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:601-466-9921
Mailing Address - Street 1:463 SELLERS RD
Mailing Address - Street 2:
Mailing Address - City:MOSELLE
Mailing Address - State:MS
Mailing Address - Zip Code:39459-9406
Mailing Address - Country:US
Mailing Address - Phone:601-466-9921
Mailing Address - Fax:
Practice Address - Street 1:463 SELLERS RD
Practice Address - Street 2:
Practice Address - City:MOSELLE
Practice Address - State:MS
Practice Address - Zip Code:39459-9406
Practice Address - Country:US
Practice Address - Phone:601-466-9921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1P2734Medicaid