1902493919 NPI number — MOLLY ARANT FLECK MSN, RN

Table of content: MOLLY ARANT FLECK MSN, RN (NPI 1902493919)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902493919 NPI number — MOLLY ARANT FLECK MSN, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLECK
Provider First Name:
MOLLY
Provider Middle Name:
ARANT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARANT
Provider Other First Name:
MOLLY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902493919
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14856 GREBE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENNINGTON
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68007-1219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-616-6978
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14856 GREBE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENNINGTON
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68007-1219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-616-6978
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  63268 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 63268 . This is a "NURSE LICENSE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".