Individual
MOLLY ELIZABETH KIDNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7120 CLEARVISTA DR STE 5300, INDIANAPOLIS, IN 46256-5300
(317) 621-7444
(317) 621-3150
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008244A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180C28
MEDICARE PTAN
IN
05
—
300017758
—
IN
01
—
P02110438
RAILROAD MEDICARE
IN
Enumeration date
07/06/2018
Last updated
04/27/2023
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