MEDICARE: MRS. MICHELLE LYNN SPOON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		OH

General Provider Information

NPI Number	:	1437018793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE LYNN SPOON

Provider Business Mailing Address
First Line	:	4570 SHEPHERDS WAY
Second Line	:
City	:	BATAVIA
State	:	OH
Zip	:	45103-3300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4570 SHEPHERDS WAY
Second Line	:
City	:	BATAVIA
State	:	OH
Zip	:	45103-3300
Country	:	US
Telephone Number	:	513-720-2484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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