MEDICARE: THE KOKO BELLA PERMANENT MAKEUP AND LASH BAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	175T00000X	Peer Specialist
2	251B00000X	Case Management Agency
3	374J00000X	Doula
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1801781331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE KOKO BELLA PERMANENT MAKEUP AND LASH BAR

Provider Business Mailing Address
First Line	:	257 KINGSMEADOW LN
Second Line	:
City	:	BLACKLICK
State	:	OH
Zip	:	43004-9204
Country	:	US
Telephone Number	:	330-371-6698
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 BALTIMORE REYNOLDSBURG RD
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8105
Country	:	US
Telephone Number	:	614-452-9821
Fax Number	:

Authorized Official
Title or Position	:	CERTIFIED PEER RECOVERY SUPPORTER
Name	:	CARNEKA J GREEN
Credential	:
Telephone Number	:	330-371-6698

Provider Enumeration Date	:	06/12/2025
Last Update Date	:	08/11/2025

Similar Medicare Providers

1932025970 — ANNETTA DENISE JOHNSON
Practice Location Address:

1929 BALTIMORE REYNOLDSBURG RD
REYNOLDSBURG, OH
43068-8105

Practice Phone: 740-400-8077
Practice Fax:

1679002299 — MRS. KELLY NICOLE LUTZ R.PH.
Practice Location Address:

6580 E MAIN ST
REYNOLDSBURG, OH
43068-2319

Practice Phone: 615-759-4184
Practice Fax: 614-759-4185

1093631012 — TIFFANY CAUSEY
Practice Location Address:

929 DIANTHUS CT
REYNOLDSBURG, OH
43068-6713

Practice Phone: 614-973-1367
Practice Fax:

1750207452 — JEANNE M CARDINALE SHARED LIVING
Practice Location Address:

6852 ROUNDELAY RD N
REYNOLDSBURG, OH
43068-1733

Practice Phone: 614-256-2133
Practice Fax:

1760941769 — CLAIRE MARIE PAPPA MD
Practice Location Address:

8050 E MAIN ST STE 3200
REYNOLDSBURG, OH
43068-2819

Practice Phone: 614-434-5437
Practice Fax: 614-434-5438

1043535586 — DR. MICHELLE CLARICE GOLLA MD
Practice Location Address:

8050 E MAIN ST STE 3200
REYNOLDSBURG, OH
43068-2819

Practice Phone: 614-434-5437
Practice Fax: 614-434-5438

Directions to “THE KOKO BELLA PERMANENT MAKEUP AND LASH BAR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.