Provider Demographics
NPI:1104033570
Name:ALLISON, BARBARA A
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:ALLISON
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 1:10579 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8509
Mailing Address - Country:US
Mailing Address - Phone:330-562-7016
Mailing Address - Fax:
Practice Address - Street 1:840 CRACKEL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-7700
Practice Address - Country:US
Practice Address - Phone:440-543-3498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2661703374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661703Medicare ID - Type UnspecifiedHOME HEALTH AID