Provider Demographics
NPI:1689213746
Name:MCCLANAHAN, ALESHA (NP)
Entity Type:Individual
Prefix:
First Name:ALESHA
Middle Name:
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALESHA
Other - Middle Name:EVELYN
Other - Last Name:DEMPSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:297 S 725 W
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:IN
Mailing Address - Zip Code:46341-9711
Mailing Address - Country:US
Mailing Address - Phone:219-689-3369
Mailing Address - Fax:
Practice Address - Street 1:4711 EVANS AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8325
Practice Address - Country:US
Practice Address - Phone:219-689-3369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2019041434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily