Provider Demographics
NPI:1215559406
Name:IKESAKES, ARIEL (PA-C)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:IKESAKES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 ODDIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-7574
Mailing Address - Country:US
Mailing Address - Phone:775-997-7300
Mailing Address - Fax:
Practice Address - Street 1:2244 ODDIE BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-7574
Practice Address - Country:US
Practice Address - Phone:775-997-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant