Provider Demographics
NPI:1659952208
Name:HARKER, MOLLY MARIE (RN)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MARIE
Last Name:HARKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28430 WITT LAKE RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8805
Mailing Address - Country:US
Mailing Address - Phone:269-625-1978
Mailing Address - Fax:
Practice Address - Street 1:677 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MI
Practice Address - Zip Code:49032-8524
Practice Address - Country:US
Practice Address - Phone:269-467-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704150387163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health