Individual
MOLLIE M ATHA
Active
Individual
MOLLIE M ATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28251850A
IN
363LP0200X
Pediatric Nurse Practitioner
28251850A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71014652A
IN
Other
Enumeration date
08/29/2022
Last updated
04/03/2026
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