Provider Demographics
NPI:1013581974
Name:DEASEL, ARIELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:DEASEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CALVARY RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1700
Mailing Address - Country:US
Mailing Address - Phone:443-504-4359
Mailing Address - Fax:
Practice Address - Street 1:615 W MACPHAIL RD STE 106
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4393
Practice Address - Country:US
Practice Address - Phone:443-504-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-16
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily