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Individual

KOLI GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-8265
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-8265

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307183
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
673849
LICENSE #673849 NY
NY
Enumeration date
12/16/2013
Last updated
09/09/2022
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