Provider Demographics
NPI:1689195927
Name:STAKELY, ARIEL P (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:P
Last Name:STAKELY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:P
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26194
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2012
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:701 MORGANTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4796
Practice Address - Country:US
Practice Address - Phone:865-982-7101
Practice Address - Fax:833-908-2132
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TNAPN22890363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program