Basic Information
| Provider Information | |||||||||
| NPI: | 1730587767 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARNOLD | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | AMANDA | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 RAWLS DR | ||||||||
| Address2: | SUITE 1500 | ||||||||
| City: | MCCOMB | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396482877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016804599 | ||||||||
| FaxNumber: | 6016804585 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 RAWLS DR | ||||||||
| Address2: | SUITE 1500 | ||||||||
| City: | MCCOMB | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396482877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016804599 | ||||||||
| FaxNumber: | 6016804585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2014 | ||||||||
| LastUpdateDate: | 05/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | R870540 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.