Provider Demographics
NPI:1043019268
Name:DEGOUNETTE, MARKEDA SHAREE
Entity type:Individual
Prefix:
First Name:MARKEDA
Middle Name:SHAREE
Last Name:DEGOUNETTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 COPPERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-3876
Mailing Address - Country:US
Mailing Address - Phone:412-628-4631
Mailing Address - Fax:
Practice Address - Street 1:344 COPPERFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-3876
Practice Address - Country:US
Practice Address - Phone:412-628-4631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X
PA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide