Provider Demographics
NPI:1144049602
Name:WILSON, MICHELLE M (AIDE)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:WILSON
Suffix:
Gender:F
Credentials:AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 N BEND RD APT L
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-7642
Mailing Address - Country:US
Mailing Address - Phone:513-706-5727
Mailing Address - Fax:
Practice Address - Street 1:3313 NORTH BEND RD APT L
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-7642
Practice Address - Country:US
Practice Address - Phone:513-706-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker