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NPI Code Detail

MEDICARE: MOLLY MARIE WILDER APRN

MEDICARE:   MOLLY MARIE WILDER  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN71604NV

General Provider Information

NPI Number : 1295682110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY MARIE WILDER APRN
Provider Business Mailing Address
First Line : 680 S ROCK BLVD
Second Line :
City : RENO
State : NV
Zip : 89502-4113
Country : US
Telephone Number : 775-329-6300
Fax Number : 775-348-3896
Provider Business Practice Location Address
First Line : 2244 ODDIE BLVD
Second Line :
City : SPARKS
State : NV
Zip : 89431-7574
Country : US
Telephone Number : 775-329-6300
Fax Number : 775-348-3896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “ MOLLY MARIE WILDER APRN” Practice Location

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