Provider Demographics
NPI:1245672450
Name:ARNOLD, JENNIFER KRAWCZYK (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KRAWCZYK
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9306
Mailing Address - Country:US
Mailing Address - Phone:843-572-7000
Mailing Address - Fax:843-572-4070
Practice Address - Street 1:8091 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9281
Practice Address - Country:US
Practice Address - Phone:843-572-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18334363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2487Medicaid
SCSC16465019OtherMEDICARE PIN
SCSC1646J577OtherMEDICARE PIN
SCSC1646H888OtherMEDICARE PIN
SCSC16466121OtherMEDICARE PIN
SCSC16466067OtherMEDICARE PIN
SCSC16466084OtherMEDICARE PIN