Provider Demographics
NPI:1922140128
Name:BILYEU, LISA KAY (PCA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KAY
Last Name:BILYEU
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PCA
Mailing Address - Street 1:410 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1077
Mailing Address - Country:US
Mailing Address - Phone:937-544-4745
Mailing Address - Fax:
Practice Address - Street 1:410 POPLAR ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1077
Practice Address - Country:US
Practice Address - Phone:937-544-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2211958Medicaid
OH1234OtherPIN