Provider Demographics
NPI:1881836757
Name:ARNOLD, ANITA LYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:LYN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-4038
Mailing Address - Country:US
Mailing Address - Phone:217-222-6550
Mailing Address - Fax:
Practice Address - Street 1:105 E QUINCY ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MO
Practice Address - Zip Code:63452-2560
Practice Address - Country:US
Practice Address - Phone:573-215-2715
Practice Address - Fax:573-497-2322
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA102156363LF0000X
IL209008003363LF0000X
MO2000145907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily