Provider Demographics
NPI:1386065100
Name:JENNIFER ARNHOLD MD PLC
Entity type:Organization
Organization Name:JENNIFER ARNHOLD MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ARNHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-770-3263
Mailing Address - Street 1:6946 OJIBWA RD
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13359 ISLE DR. SUITE 2
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-2222
Practice Address - Country:US
Practice Address - Phone:218-454-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1043283203Medicaid