Healthcare Provider Details

I. General information

NPI: 1174027486
Provider Name (Legal Business Name): ERIN MOLLOY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST FL 1
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 859-562-1085
  • Fax: 859-257-5152
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number60685
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: