Provider Demographics
NPI:1215467014
Name:TRAUB, ARIELLE NIKOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:NIKOLE
Last Name:TRAUB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:NIKOLE
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8051 S EMERSON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8633
Mailing Address - Country:US
Mailing Address - Phone:317-865-3600
Mailing Address - Fax:
Practice Address - Street 1:8051 S EMERSON AVE STE 400
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237
Practice Address - Country:US
Practice Address - Phone:317-865-3600
Practice Address - Fax:317-885-3850
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10002271A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300005447Medicaid