Individual
MOLLY MARIE CORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
3050 MACK ROAD, MLC 11032, FAIRFIELD, OH 45014-5379
(513) 636-8259
(513) 636-6419
Mailing address
3050 MACK ROAD, MLC 11032, FAIRFIELD, OH 45014-5379
(513) 636-8259
(513) 636-6419
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.14896
OH
363LP0200X
Pediatric Nurse Practitioner
COA14896NP
OH
363LP0200X
Pediatric Nurse Practitioner
SP016635
PA
Other
Enumeration date
09/14/2013
Last updated
03/30/2021
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