Provider Demographics
NPI:1427126713
Name:ARNOLD, SANENTHIA NYSHAE
Entity type:Individual
Prefix:
First Name:SANENTHIA
Middle Name:NYSHAE
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:PO BOX 467941
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31146-7941
Mailing Address - Country:US
Mailing Address - Phone:678-612-6774
Mailing Address - Fax:
Practice Address - Street 1:371 KILCREASE RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:GA
Practice Address - Zip Code:30011-3356
Practice Address - Country:US
Practice Address - Phone:678-612-6774
Practice Address - Fax:678-425-0363
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2022372600000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered372600000XNursing Service Related ProvidersAdult Companion
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide