Individual provider Active NPI

Jacqueline Arnold, RN

  • Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1093139206
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN25092 Issued in NV
Practice address
625 Shadow Lane
Las Vegas, NV 89106
Phone
(702) 759-0809
Fax
(702) 633-0975
NPI assigned
Feb 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN25092 NV Primary

Addresses

Primary practice location

625 Shadow Lane
Las Vegas, NV 89106

Mailing address

625 Shadow LN
Las Vegas, NV 89106-4118
Phone (702) 759-0809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN25092NVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Nevada Health District Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1093139206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064118",
            "telephone_number": "702-759-0809",
            "fax_number": "702-633-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-759-0809",
            "fax_number": "702-633-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN25092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.