Provider Demographics
NPI:1083498786
Name:ALLMON-WILBON, MICHELLE P
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:P
Last Name:ALLMON-WILBON
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 1:5659 SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3050
Mailing Address - Country:US
Mailing Address - Phone:216-778-0858
Mailing Address - Fax:
Practice Address - Street 1:5659 SHAWNEE DR # DN
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3050
Practice Address - Country:US
Practice Address - Phone:216-778-0858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide