Basic Information
| Provider Information | |||||||||
| NPI: | 1073643458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636799 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135696422 | ||||||||
| FaxNumber: | 5135695199 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 STRAIGHT STREET | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452191069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136240934 | ||||||||
| FaxNumber: | 5136240999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 08/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | NP-09335 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | RN 231051 | 01 | OH | RN LICENSE | OTHER | RX 09335 - EX1 | 01 | OH | CERTIFICATE TO PRESCRIBE | OTHER | NP-09335 | 01 | OH | NURSE PRACTITIONER LICENS | OTHER | 2923733 | 05 | OH | MEDICAID |