Provider Demographics
NPI:1932865748
Name:DEJARNETTE, QURAN
Entity Type:Individual
Prefix:MRS
First Name:QURAN
Middle Name:
Last Name:DEJARNETTE
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 1:16798 KENT ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-3733
Mailing Address - Country:US
Mailing Address - Phone:216-470-6501
Mailing Address - Fax:
Practice Address - Street 1:16798 KENT ST
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-3733
Practice Address - Country:US
Practice Address - Phone:216-470-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide