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General NPI Number Information
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NPI Number | 1609631209
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Entity Type | Individual
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Provider Name | DYLAN MOLENHOUR MSN, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1402 N FLORENCE AVE STE B
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City | CLAREMORE
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State | OK
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Zip | 74017-3159
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Country | US
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Telephone | 918-608-0380
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Fax |
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Provider Business Mailing Address
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Address Line | 4657 S WINSTON AVE
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City | TULSA
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State | OK
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Zip | 74135-3215
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Country | US
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Telephone | 318-754-5754
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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 | 218671
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0102664-C-NP
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License Number State | CO
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