Provider Demographics
NPI:1336866425
Name:ARNOLD, ABBEY LYNNE (ACNP)
Entity type:Individual
Prefix:MRS
First Name:ABBEY
Middle Name:LYNNE
Last Name:ARNOLD
Suffix:
Gender:
Credentials:ACNP
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Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-286-1967
Mailing Address - Fax:314-286-1985
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV NEURO AGING AND DEMENTIA, STE 6C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-286-1967
Practice Address - Fax:314-286-1985
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2022015785363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420116556Medicaid