Provider Demographics
NPI:1174616379
Name:SPEARING, MOLLY MARIE (NP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MARIE
Last Name:SPEARING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8101 CLEARVISTA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256
Practice Address - Country:US
Practice Address - Phone:317-621-5390
Practice Address - Fax:317-621-5885
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71001289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200406010Medicaid
500025170Medicare PIN
IN151560ZZZZMedicare PIN
IN151700RMedicare PIN
500025170Medicare PIN