Provider Demographics
NPI:1528800588
Name:ARNOLD, AMY (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 WEDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2845
Mailing Address - Country:US
Mailing Address - Phone:860-878-5124
Mailing Address - Fax:
Practice Address - Street 1:270 FARMINGTON AVE STE 309
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1953
Practice Address - Country:US
Practice Address - Phone:860-677-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT89401163WS0200X
CT13535363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool