Provider Demographics
NPI:1285235697
Name:MILLHOUSE, TENNIE E
Entity type:Individual
Prefix:
First Name:TENNIE
Middle Name:E
Last Name:MILLHOUSE
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 1:3749 W 128TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-4527
Mailing Address - Country:US
Mailing Address - Phone:216-410-3711
Mailing Address - Fax:
Practice Address - Street 1:12808 SUMMERLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5167
Practice Address - Country:US
Practice Address - Phone:216-410-3711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health