Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ko Nurse Practitioner, LLC

Organization Physician Assistant · NPI 1912287624

Ko Nurse Practitioner, LLC is a Physician Assistant in Lakewood, Ohio. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15800 Detroit Ave
Lakewood, OH 44107-3748
Phone: (216) 226-8700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1912287624
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official George Khuri — Owner · (216) 521-2255
NPI enumeratedAugust 25, 2011
Last updated in NPPESSeptember 20, 2016
Mailing addressPo Box 74692, Cleveland, OH 44194-0775

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