Provider Demographics
NPI:1831528769
Name:PITURA, MOLLIE S (APRN)
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:S
Last Name:PITURA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1936
Mailing Address - Country:US
Mailing Address - Phone:270-885-8505
Mailing Address - Fax:270-885-8564
Practice Address - Street 1:1722 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1936
Practice Address - Country:US
Practice Address - Phone:270-885-8505
Practice Address - Fax:270-885-8564
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008371363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100270280Medicaid