Provider Demographics
NPI:1962008110
Name:KOLBE, LINDA R
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:KOLBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11347 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-1465
Mailing Address - Country:US
Mailing Address - Phone:216-543-0009
Mailing Address - Fax:
Practice Address - Street 1:11347 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-1465
Practice Address - Country:US
Practice Address - Phone:216-543-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No347C00000XTransportation ServicesPrivate Vehicle