Provider Demographics
NPI:1558172551
Name:STALLWORTH, MILASHEY LAFAYETTE
Entity type:Individual
Prefix:
First Name:MILASHEY
Middle Name:LAFAYETTE
Last Name:STALLWORTH
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 1:1388 MEREDITH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3256
Mailing Address - Country:US
Mailing Address - Phone:513-703-3664
Mailing Address - Fax:
Practice Address - Street 1:1388 MEREDITH DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3256
Practice Address - Country:US
Practice Address - Phone:513-703-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant