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General NPI Number Information
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NPI Number | 1124940002
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Entity Type | Individual
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Provider Name | MOLLY ANNE SHREVES
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Gender | Female
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 3901 FAULKNER DR
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City | LINCOLN
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State | NE
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Zip | 68516-4738
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Country | US
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Telephone | 402-875-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 6162 BLACKSTONE RD
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City | LINCOLN
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State | NE
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Zip | 68526-9538
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Country | US
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Telephone | 605-661-9690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 117113
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License Number State | NE
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