1326144932 NPI number — LYNDA J ARNOLD ARNP, CWCN

Table of content: LYNDA J ARNOLD ARNP, CWCN (NPI 1326144932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326144932 NPI number — LYNDA J ARNOLD ARNP, CWCN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARNOLD
Provider First Name:
LYNDA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, CWCN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326144932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 238
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAYDEN
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83835-0238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-664-3301
Provider Business Mailing Address Fax Number:
877-653-2694

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
296 W SUNSET AVE STE 14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COEUR D ALENE
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83815-8367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-967-4771
Provider Business Practice Location Address Fax Number:
208-683-8101
Provider Enumeration Date:
09/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  NP-770A , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 807684700 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: G000301387 . This is a "MEDICARE GROUP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00390223 . This is a "MEDICARE RAILROAD CARRIER" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




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