Healthcare Provider Details

I. General information

NPI: 1174440002
Provider Name (Legal Business Name): MOLLY ANN TUON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

IV. Provider business mailing address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-2000
  • Fax:
Mailing address:
  • Phone: 859-301-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4052856
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: