Healthcare Provider Details

I. General information

NPI: 1215559406
Provider Name (Legal Business Name): ARIEL IKESAKES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 ODDIE BLVD
SPARKS NV
89431-7574
US

IV. Provider business mailing address

680 S ROCK BLVD
RENO NV
89502-4113
US

V. Phone/Fax

Practice location:
  • Phone: 775-997-7300
  • Fax:
Mailing address:
  • Phone: 775-329-6300
  • Fax: 775-348-3896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2539
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA0549
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: