Provider Demographics
NPI:1265231898
Name:ALLEN, LILLIAN DANIELLE (STNA)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:DANIELLE
Last Name:ALLEN
Suffix:
Gender:
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 WADE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3305
Mailing Address - Country:US
Mailing Address - Phone:216-849-1875
Mailing Address - Fax:
Practice Address - Street 1:7707 WADE PARK AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3305
Practice Address - Country:US
Practice Address - Phone:216-849-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400743610408374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide