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NPI Code Detail

MEDICARE: MOLLY SHAKER BADR FNP-C

MEDICARE: MOLLY SHAKER BADR FNP-C
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
1363LF0000XFamily Nurse Practitioner356462OH

General Provider Information

NPI Number : 1407392277
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY SHAKER BADR FNP-C
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4613 MARBURG AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-5005
Country : US
Telephone Number : 615-425-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2017
Last Update Date : 01/17/2017

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