Basic Information
| Provider Information | |||||||||
| NPI: | 1912946328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALESHIRE | ||||||||
| FirstName: | MOLLIE | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 317 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WILMORE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403901323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598580339 | ||||||||
| FaxNumber: | 8598580341 | ||||||||
| Practice Location | |||||||||
| Address1: | 317 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WILMORE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403901323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598580339 | ||||||||
| FaxNumber: | 8598580341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 09/05/2016 | ||||||||
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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 | 363LP2300X | 3004165 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
ID Information
| ID | Type | State | Issuer | Description | 78010949 | 05 | KY | MEDICAID | 000000311801 | 01 | KY | ANTHEM | OTHER |