Provider Demographics
NPI:1700670452
Name:MCENTYRE, LADENA DESIREE (CNA, MEDICATION AIDE)
Entity type:Individual
Prefix:
First Name:LADENA
Middle Name:DESIREE
Last Name:MCENTYRE
Suffix:
Gender:F
Credentials:CNA, MEDICATION AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6464
Mailing Address - Country:US
Mailing Address - Phone:704-284-8038
Mailing Address - Fax:
Practice Address - Street 1:800 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6464
Practice Address - Country:US
Practice Address - Phone:704-284-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC527130376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide