Healthcare Provider Details

I. General information

NPI: 1962008110
Provider Name (Legal Business Name): LINDA R KOLBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 12/11/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11347 CHILLICOTHE RD
CHESTERLAND OH
44026-1465
US

IV. Provider business mailing address

11347 CHILLICOTHE RD
CHESTERLAND OH
44026-1465
US

V. Phone/Fax

Practice location:
  • Phone: 216-543-0009
  • Fax:
Mailing address:
  • Phone: 216-543-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: