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General NPI Number Information
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NPI Number | 1265190730
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Entity Type | Individual
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Provider Name | MOLLY ELIZABETH MATTHEWS NP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 13345 ILLINOIS ST
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City | CARMEL
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State | IN
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Zip | 46032-3318
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Country | US
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Telephone | 317-396-1160
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Fax | 317-352-3431
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Provider Business Mailing Address
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Address Line | 13345 ILLINOIS ST
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City | CARMEL
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State | IN
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Zip | 46032-3318
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Country | US
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Telephone | 317-396-1160
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Fax | 317-352-3431
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71012134A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28209720A
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License Number State | IN
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