Provider Demographics
NPI:1952512113
Name:BILYEU, MICHELLE LEE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEE
Last Name:BILYEU
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:PENNYWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 E 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45144
Mailing Address - Country:US
Mailing Address - Phone:937-779-6602
Mailing Address - Fax:937-549-2502
Practice Address - Street 1:22 E 4TH STREET
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144
Practice Address - Country:US
Practice Address - Phone:937-779-6602
Practice Address - Fax:937-549-2502
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH377962910299374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2267014Medicaid