Provider Demographics
NPI:1760181887
Name:INGBER, ARIANNE RENEE (PA-C)
Entity type:Individual
Prefix:
First Name:ARIANNE
Middle Name:RENEE
Last Name:INGBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3327
Mailing Address - Country:US
Mailing Address - Phone:917-502-5827
Mailing Address - Fax:
Practice Address - Street 1:275 ROBERT ROSE DR BLDG B
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-6347
Practice Address - Country:US
Practice Address - Phone:615-295-8272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5432363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1203244OtherNCCPA CERTIFICATION
TN5432OtherMEDICAL LICENSE