Healthcare Provider Details

I. General information

NPI: 1093385809
Provider Name (Legal Business Name): MOLLY SLY DNP, ARNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 48TH ST STE 260
WEST DES MOINES IA
50266-6726
US

IV. Provider business mailing address

787 SE 61ST ST
PLEASANT HILL IA
50327-5083
US

V. Phone/Fax

Practice location:
  • Phone: 515-348-6380
  • Fax: 515-452-0565
Mailing address:
  • Phone: 515-745-7026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG163952
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: