Provider Demographics
NPI:1043774789
Name:CAMPBELL, ARIELLE M (PA)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12369
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0048
Mailing Address - Country:US
Mailing Address - Phone:844-893-0012
Mailing Address - Fax:
Practice Address - Street 1:5002 CROSSINGS CIR STE 100
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8496
Practice Address - Country:US
Practice Address - Phone:844-893-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4450363A00000X
MO2019002633363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant