Provider Demographics
NPI:1205516960
Name:ALLEN, ROSHEDIA MAE
Entity type:Individual
Prefix:
First Name:ROSHEDIA
Middle Name:MAE
Last Name:ALLEN
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 1:8166 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-9532
Mailing Address - Country:US
Mailing Address - Phone:513-406-1769
Mailing Address - Fax:
Practice Address - Street 1:8166 W MILL ST
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-9532
Practice Address - Country:US
Practice Address - Phone:513-406-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide