Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2012022609 | MO |
NPI | 1003162702 |
---|---|
Provider Name | Sydney Lynn Arnold |
First Address | Pronceton, MO 64673-1418 |
Second Address | Pronceton, MO 64673-1418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2012 |
Last Update Date | 31/07/2015 |