Provider Demographics
NPI:1861030454
Name:GEORGE, MICHELE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:ANN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 LONGTON RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2749
Mailing Address - Country:US
Mailing Address - Phone:440-532-1493
Mailing Address - Fax:
Practice Address - Street 1:5127 LONGTON RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2749
Practice Address - Country:US
Practice Address - Phone:440-532-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-15
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN354640163WH1000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice