Provider Demographics
NPI:1659243038
Name:ARNOLD, KEAGAN LEE
Entity type:Individual
Prefix:
First Name:KEAGAN
Middle Name:LEE
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S 90TH ST APT 242
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68520-8308
Mailing Address - Country:US
Mailing Address - Phone:308-765-0532
Mailing Address - Fax:
Practice Address - Street 1:7501 O ST STE 105
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2485
Practice Address - Country:US
Practice Address - Phone:402-630-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion