Provider Demographics
NPI:1245395284
Name:FLETCHER, MICHALENE
Entity Type:Individual
Prefix:
First Name:MICHALENE
Middle Name:
Last Name:FLETCHER
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 1:1394 ORLANDO AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320
Mailing Address - Country:US
Mailing Address - Phone:440-541-5060
Mailing Address - Fax:
Practice Address - Street 1:1940 NEWTON STREET
Practice Address - Street 2:SELF SUPPORT PERSONAL CARE
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305
Practice Address - Country:US
Practice Address - Phone:330-784-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide