Provider Demographics
NPI:1437858354
Name:LOSH, MOLLIE MAE
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:MAE
Last Name:LOSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TECUMSEH TRL
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1055
Mailing Address - Country:US
Mailing Address - Phone:419-890-2621
Mailing Address - Fax:
Practice Address - Street 1:201 TECUMSEH TRL
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1055
Practice Address - Country:US
Practice Address - Phone:419-890-2621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker