Provider Demographics
NPI:1740057603
Name:MOLLY ECKERT APRN PLLC
Entity type:Organization
Organization Name:MOLLY ECKERT APRN PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-567-1950
Mailing Address - Street 1:8414 FARM RD STE 180
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-8007
Mailing Address - Country:US
Mailing Address - Phone:725-567-1950
Mailing Address - Fax:
Practice Address - Street 1:8414 FARM RD STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-8007
Practice Address - Country:US
Practice Address - Phone:725-567-1950
Practice Address - Fax:888-690-5051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOLLY ECKERT APRN PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-11
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty