Provider Demographics
NPI:1457866451
Name:MCCORKLE, TENIKA CHIQUE (DNP, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:TENIKA
Middle Name:CHIQUE
Last Name:MCCORKLE
Suffix:
Gender:F
Credentials:DNP, FNP-BC
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Mailing Address - Street 1:648 HANES MALL BLVD # 314
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5670
Mailing Address - Country:US
Mailing Address - Phone:336-510-9930
Mailing Address - Fax:336-331-3303
Practice Address - Street 1:129 FAYETTE ST STE 101
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3637
Practice Address - Country:US
Practice Address - Phone:336-510-9930
Practice Address - Fax:336-331-3303
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCMCCO-2WLLCG363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily