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Individual
MOLLIE HANLON
Active
Individual
MOLLIE HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28106541A
IN
363L00000X
Nurse Practitioner
Primary
71002613A
IN
363LA2200X
Adult Health Nurse Practitioner
71002613A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000558684
ANTHEM PROVIDER NUMBER
IN
01
—
000000590215
ANTHEM PIN
IN
05
—
200893380
—
IN
Enumeration date
02/27/2008
Last updated
04/01/2024
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