Provider Demographics
NPI:1467140467
Name:MCALPINE, DEJOIRE TEKIESHA
Entity Type:Individual
Prefix:
First Name:DEJOIRE
Middle Name:TEKIESHA
Last Name:MCALPINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3946 REID AVE LOT G2
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-5464
Mailing Address - Country:US
Mailing Address - Phone:440-662-3834
Mailing Address - Fax:
Practice Address - Street 1:3946 REID AVE LOT G2
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-5464
Practice Address - Country:US
Practice Address - Phone:440-662-3834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide