Provider Demographics
NPI:1538979059
Name:MUNDELL, ARNESA
Entity type:Individual
Prefix:
First Name:ARNESA
Middle Name:
Last Name:MUNDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8528 SW HEGENER DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1105
Mailing Address - Country:US
Mailing Address - Phone:561-570-9587
Mailing Address - Fax:
Practice Address - Street 1:8528 SW HEGENER DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1105
Practice Address - Country:US
Practice Address - Phone:561-570-9587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9481988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse