Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 71011535A | IN |
NPI | 1033884432 |
---|---|
Provider Name | Molly Taylor |
First Address | Carmel, IN 46033-8224 |
Second Address | Carmel, IN 46032-1744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2021 |
Last Update Date | 15/10/2021 |