Individual
KELLY MOLENDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Mailing address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28182312A
IN
Other
Enumeration date
11/22/2015
Last updated
11/22/2015
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