Provider Demographics
NPI:1043812118
Name:BILLUE, LONNAI D (HHA)
Entity Type:Individual
Prefix:
First Name:LONNAI
Middle Name:D
Last Name:BILLUE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19952 VAUGHAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-2062
Mailing Address - Country:US
Mailing Address - Phone:313-768-6910
Mailing Address - Fax:
Practice Address - Street 1:19952 VAUGHAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-2062
Practice Address - Country:US
Practice Address - Phone:313-768-6910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health