Provider Demographics
NPI:1417661364
Name:CHAVIS, ARIEL DEANN (APRN)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:DEANN
Last Name:CHAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5708
Mailing Address - Country:US
Mailing Address - Phone:931-263-0581
Mailing Address - Fax:931-263-0582
Practice Address - Street 1:2660 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5708
Practice Address - Country:US
Practice Address - Phone:931-263-0581
Practice Address - Fax:931-263-0582
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS916915163W00000X
AL3-001163363LF0000X
TN34020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse