MEDICARE: MRS. BRITANI DIANE MOLARGIK FNP-BC

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
1	208800000X	Urology Physician	71016653A	IN

General Provider Information

NPI Number	:	1457144206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITANI DIANE MOLARGIK FNP-BC

Provider Business Mailing Address
First Line	:	1508 BERWICK LN
Second Line	:
City	:	NEW HAVEN
State	:	IN
Zip	:	46774-2014
Country	:	US
Telephone Number	:	260-515-3512
Fax Number	:

Provider Business Practice Location Address
First Line	:	7920 W JEFFERSON BLVD STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4166
Country	:	US
Telephone Number	:	260-702-9515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2025
Last Update Date	:	05/26/2025

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