Provider Demographics
NPI:1730843079
Name:HAFLE, ARIELLE (AGNP-C)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:HAFLE
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGNP-C
Mailing Address - Street 1:628 SKODBORG DR
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-2654
Mailing Address - Country:US
Mailing Address - Phone:937-533-5006
Mailing Address - Fax:
Practice Address - Street 1:4160 LITTLE YORK RD STE 20
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-5803
Practice Address - Country:US
Practice Address - Phone:937-454-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030046363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner