Provider Demographics
NPI:1396465431
Name:ARNOLD, MARY J (RN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:RALSTON
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3909
Mailing Address - Country:US
Mailing Address - Phone:402-968-2875
Mailing Address - Fax:
Practice Address - Street 1:7510 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:RALSTON
Practice Address - State:NE
Practice Address - Zip Code:68127-3909
Practice Address - Country:US
Practice Address - Phone:402-968-2875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE83030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse