Provider Demographics
NPI:1750027967
Name:CHOQUETTE, ADORA ELISE
Entity Type:Individual
Prefix:
First Name:ADORA
Middle Name:ELISE
Last Name:CHOQUETTE
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 1:1751 POPLAR AVE APT 18
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6437
Mailing Address - Country:US
Mailing Address - Phone:512-999-5440
Mailing Address - Fax:
Practice Address - Street 1:400 INNOVATION DR
Practice Address - Street 2:#126
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-3811
Practice Address - Country:US
Practice Address - Phone:901-678-2147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program