Individual
MOLLY S. KLIEWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4000
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1499
(719) 546-4000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
115049
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
115049
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19484216
—
CO
Enumeration date
11/30/2006
Last updated
01/03/2023
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