Provider Demographics
NPI:1285424614
Name:LEMONS, MISHA
Entity type:Individual
Prefix:
First Name:MISHA
Middle Name:
Last Name:LEMONS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66448
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-6448
Mailing Address - Country:US
Mailing Address - Phone:586-863-8622
Mailing Address - Fax:
Practice Address - Street 1:19365 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-7206
Practice Address - Country:US
Practice Address - Phone:586-203-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide