Provider Demographics
NPI:1730156258
Name:ARNOLD, NANCY ANN (RNC, OGNP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RNC, OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 BOSTONS FARM DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-3151
Mailing Address - Country:US
Mailing Address - Phone:314-291-0088
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 4005
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-567-5016
Practice Address - Fax:314-567-1846
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO089234363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000080526Medicare ID - Type Unspecified
MOS23401Medicare UPIN