Provider Demographics
NPI:1053703488
Name:ARNETT, JARED R (PMHNP)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:R
Last Name:ARNETT
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-0366
Mailing Address - Country:US
Mailing Address - Phone:735-883-4773
Mailing Address - Fax:
Practice Address - Street 1:753 POINTE BASSE DR
Practice Address - Street 2:
Practice Address - City:STE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1820
Practice Address - Country:US
Practice Address - Phone:573-883-2782
Practice Address - Fax:573-883-3789
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015004271363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health