Basic Information
| Provider Information | |||||||||
| NPI: | 1619191772 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARNOLD | ||||||||
| FirstName: | PEGGY | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 351 NEW SHACKLE ISLAND RD | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370752300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158240552 | ||||||||
| FaxNumber: | 6158249771 | ||||||||
| Practice Location | |||||||||
| Address1: | 351 NEW SHACKLE ISLAND RD | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370752300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158240552 | ||||||||
| FaxNumber: | 6158249771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 96189 | TN | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 96189 | 01 | TN | RN | OTHER |