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Individual

MOLLY S DODT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
3920 ST FRANCIS WAY STE 209, LAFAYETTE, IN 47905-4917
(765) 775-2830
(765) 775-2826
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71006548A
IN
363LA2200X
Adult Health Nurse Practitioner
71006548A
IN
363LG0600X
Gerontology Nurse Practitioner
71006548A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201392760
IN
Enumeration date
09/16/2016
Last updated
05/23/2023
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