Healthcare Provider Details

I. General information

NPI: 1063214435
Provider Name (Legal Business Name): MOLLY ELPERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6211 WATERFORD BLVD
EVANSVILLE IN
47715-2869
US

IV. Provider business mailing address

4301 BREEZE RD
MOUNT VERNON IN
47620-7154
US

V. Phone/Fax

Practice location:
  • Phone: 812-465-6202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number28236097A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: