Provider Demographics
NPI:1376045187
Name:SHEELEY, MOLLY ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:SHEELEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 JOSEPH E SANKER BLVD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1979
Mailing Address - Country:US
Mailing Address - Phone:513-841-7404
Mailing Address - Fax:513-841-7402
Practice Address - Street 1:350 THOMAS MORE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5460
Practice Address - Country:US
Practice Address - Phone:513-841-7404
Practice Address - Fax:513-841-7402
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022368363LF0000X
KY3012185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily