Provider Demographics
NPI:1154726867
Name:ARNOLD, NICOLE S
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:S
Last Name:ARNOLD
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 1:23527 S FRONTENAC DR
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4948
Mailing Address - Country:US
Mailing Address - Phone:216-712-2233
Mailing Address - Fax:
Practice Address - Street 1:23527 S FRONTENAC DR
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-4948
Practice Address - Country:US
Practice Address - Phone:216-712-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401417720712376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide