Kellie L Arnold, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Susanville, CA
NPI 1043844947 · NPPES record last updated May 4, 2020
Key facts
- NPI
- 1043844947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95014203 (CA)
- Practice address
- 1850 Spring Ridge Dr
Susanville, CA 96130-6100 - Phone
- (530) 251-5000
- NPI assigned
- Feb 28, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Health
Practice addresses (Care Compare)
1680 Bunyan Rd
Susanville, CA 96130-3133
Phone (530) 257-5730
Hospital & facility affiliations
- Banner Lassen Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200507003012 | CA | Practitioner - Nurse Practitioner | 8022449081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 624057 | CA | MD | Registered Nurse |
| 95014203 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Health | Current |
Accepting new patients | |
| Banner Health | Current |
Accepting new patients |
Locations
1680 Bunyan Rd
Susanville, CA 96130
Phone (530) 252-2235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 624057 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95014203 | CA | Yes |
Addresses
Primary practice location
1850 Spring Ridge Dr
Susanville, CA 96130-6100
Mailing address
PO Box 270694
Susanville, CA 96127-0013
Phone (530) 310-8259
Other providers in Susanville, CA
- John A. Anderson
- Lindsey Anderson
- James Ware Angell
- Grace Golliday Appel
- Tiffany Armstrong
- Shayla Jean Ashmore
- Frederick Boyd Autenrieb
- Maryann Bacon
- Cecilia Badger
- Elizabeth Baker
All providers in Susanville, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.