Provider Demographics
NPI:1477073047
Name:SHAGENA, ARIEL ANN (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:ARIEL
Middle Name:ANN
Last Name:SHAGENA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 W EISENHOWER PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6196
Mailing Address - Country:US
Mailing Address - Phone:734-769-3702
Mailing Address - Fax:734-769-2075
Practice Address - Street 1:760 W EISENHOWER PKWY STE 208
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6196
Practice Address - Country:US
Practice Address - Phone:734-769-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704306170363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics