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Individual

MOLLY LOUCKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
9500 EUCLID AVE, E-11, CLEVELAND, OH 44195-0001
(216) 444-4846
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.019703
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APRN.CNP.019703
CERTIFICATE OF AUTHORITY FOR THE STATE OF OHIO
OH
Enumeration date
08/17/2016
Last updated
08/17/2016
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