Provider Demographics
NPI:1942632021
Name:ARNOLD, KATIE LANE (MAE, ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:LANE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MAE, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 OWL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-7620
Mailing Address - Country:US
Mailing Address - Phone:865-617-3252
Mailing Address - Fax:615-547-1309
Practice Address - Street 1:1 CUMBERLAND SQ
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3408
Practice Address - Country:US
Practice Address - Phone:615-547-1334
Practice Address - Fax:615-547-1309
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer