Provider Demographics
NPI:1740165588
Name:BYAS, EBONEE DIANNE
Entity type:Individual
Prefix:
First Name:EBONEE
Middle Name:DIANNE
Last Name:BYAS
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 1:4447 BLUEBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3320
Mailing Address - Country:US
Mailing Address - Phone:513-764-0898
Mailing Address - Fax:
Practice Address - Street 1:4447 BLUEBERRY AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3320
Practice Address - Country:US
Practice Address - Phone:513-764-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUG184422374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty