Provider Demographics
NPI:1902493919
Name:FLECK, MOLLY ARANT (MSN, RN)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:ARANT
Last Name:FLECK
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANN
Other - Last Name:ARANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14856 GREBE ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1219
Mailing Address - Country:US
Mailing Address - Phone:402-616-6978
Mailing Address - Fax:
Practice Address - Street 1:14856 GREBE ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1219
Practice Address - Country:US
Practice Address - Phone:402-616-6978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63268163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE63268OtherNURSE LICENSE