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General NPI Number Information
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NPI Number | 1174452254
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Entity Type | Individual
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Provider Name | KELLY GREEN RRT
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 2121 HUGHES DR
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City | TOLEDO
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State | OH
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Zip | 43606-3857
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Country | US
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Telephone | 419-291-5569
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Fax |
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Provider Business Mailing Address
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Address Line | 16119 POTTER RD
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City | WESTON
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State | OH
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Zip | 43569-9761
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Country | US
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Telephone | 513-349-3945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2279P3900X
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Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
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License Number | 98794
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License Number State | OH
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