Provider Demographics
NPI:1649007451
Name:ARNOLD, MCKENZIE (DNP)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 ELLA AVE
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:IA
Mailing Address - Zip Code:52340-7901
Mailing Address - Country:US
Mailing Address - Phone:917-693-3113
Mailing Address - Fax:
Practice Address - Street 1:404 E BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2800
Practice Address - Country:US
Practice Address - Phone:319-351-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA162997163W00000X
IAA181499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse