Linda Sue Green, P.A.-C
Individual provider Active NPI Physician Assistant · Minerva, OH
NPI 1619979721 · NPPES record last updated Jun 23, 2020
Key facts
- NPI
- 1619979721
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 50000166 (OH)
- Practice address
- 1028 E Lincolnway
Minerva, OH 44657-1216 - Phone
- (330) 868-6044
- NPI assigned
- Aug 10, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50000166 | OH | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50000166 | OH | Yes |
Addresses
Primary practice location
1028 E Lincolnway
Minerva, OH 44657-1216
Mailing address
3515 Massillon Rd
Suite 300
Uniontown, OH 44685-6400
Phone (330) 868-6044
Other providers in Minerva, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.