Provider Demographics
NPI:1992680383
Name:GREEN, COREY MAIRE (NP)
Entity type:Individual
Prefix:MRS
First Name:COREY
Middle Name:MAIRE
Last Name:GREEN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:9241 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9527
Mailing Address - Country:US
Mailing Address - Phone:330-268-0733
Mailing Address - Fax:330-452-7012
Practice Address - Street 1:2600 TUSCARAWAS ST W STE 100
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4696
Practice Address - Country:US
Practice Address - Phone:216-403-4814
Practice Address - Fax:330-452-7012
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0039918363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology