Individual provider Active NPI

Molly S. Kliewer, FNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1598833691
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
115049 Issued in CO
Practice address
1600 W 24TH St
Pueblo, CO 81003-1411
Phone
(719) 546-4000
NPI assigned
Nov 30, 2006
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 115049 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 115049 CO Primary

Addresses

Primary practice location

1600 W 24TH St
Pueblo, CO 81003-1411

Mailing address

1600 W 24TH St
Pueblo, CO 81003-1499
Phone (719) 546-4000

Other identifiers 1

IdentifierTypeStateIssuer
19484216MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
115049COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Orthopedic Professional Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1598833691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031499",
            "telephone_number": "719-546-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIEWER",
        "first_name": "MOLLY",
        "middle_name": "S.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "115049",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "115049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19484216",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.