Provider Demographics
NPI:1366147621
Name:ARNOLD, ALYSSA JEAN
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JEAN
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 1:846N ASH RD
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-9351
Mailing Address - Country:US
Mailing Address - Phone:906-450-4255
Mailing Address - Fax:
Practice Address - Street 1:7041W TANNERY RD
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-9201
Practice Address - Country:US
Practice Address - Phone:906-286-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion