Healthcare Provider Details

I. General information

NPI: 1881465490
Provider Name (Legal Business Name): MOLLY LYNN LEDFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 S PINE ST
PINEVILLE KY
40977-1646
US

IV. Provider business mailing address

PO BOX 40
WHITESBURG KY
41858-0040
US

V. Phone/Fax

Practice location:
  • Phone: 606-337-3500
  • Fax: 606-337-5233
Mailing address:
  • Phone: 606-633-4823
  • Fax: 606-633-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4060402
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: