Provider Demographics
NPI:1558040022
Name:CALVERT, AUNTAESHA DONSHAE (HHA)
Entity type:Individual
Prefix:
First Name:AUNTAESHA
Middle Name:DONSHAE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:AUNTAESHA
Other - Middle Name:DONSHAE
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HHA
Mailing Address - Street 1:8555 CEDAR PLACE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2344
Mailing Address - Country:US
Mailing Address - Phone:317-827-8850
Mailing Address - Fax:317-930-1325
Practice Address - Street 1:8555 CEDAR PLACE DR STE 114
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-2344
Practice Address - Country:US
Practice Address - Phone:317-827-8850
Practice Address - Fax:317-930-1325
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN015780374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide