Healthcare Provider Details

I. General information

NPI: 1497573265
Provider Name (Legal Business Name): BETHANY MOLNAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

2188 KENYON ST
LOUISVILLE OH
44641-9021
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3588
  • Fax:
Mailing address:
  • Phone: 330-317-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.470548
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0037748
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: