Individual
CAROLYN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1634 BELMAR RD, CLEVELAND HTS, OH 44118-1156
(216) 407-1764
Mailing address
1634 BELMAR RD, CLEVELAND HEIGHTS, OH 44118-1156
(216) 407-1764
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN 154793-M-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LPN PN154793
—
OH
Enumeration date
06/24/2014
Last updated
07/09/2015
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