Provider Demographics
NPI:1417981523
Name:BORING, MOLLY (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:BORING
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 GLIDEPATH WAY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-4133
Mailing Address - Country:US
Mailing Address - Phone:615-449-5771
Mailing Address - Fax:615-449-5740
Practice Address - Street 1:3786 CENTRAL PIKE STE 110
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3498
Practice Address - Country:US
Practice Address - Phone:615-964-5941
Practice Address - Fax:615-964-5948
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3026483OtherBCBS PROVIDER NUMBER
TN3043372Medicaid
TN3905054Medicare ID - Type Unspecified
TN3043372Medicaid