Provider Demographics
NPI:1902263155
Name:ESHEMITAN, DEANNA
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:ESHEMITAN
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 1:44202 W PALO CEDRO RD
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-3638
Mailing Address - Country:US
Mailing Address - Phone:520-217-0029
Mailing Address - Fax:
Practice Address - Street 1:44202 W PALO CEDRO RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-3638
Practice Address - Country:US
Practice Address - Phone:520-217-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility