Johnson, Molly L

Johnson, Molly L is an individual health care provider with primary practice located at 210 Pepsi Way , Wytheville VA 24382-3030. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Molly L can be contacted via phone (276) 625-2354.

Contact Information

Primary practice address
210 Pepsi Way Wytheville VA 24382-3030
Phone: (276) 625-2354
Fax: (276) 625-2357
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024170209 Virginia

Profile Details

NPI number 1962757369
LBN Legal business name Johnson, Molly L
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2012
Last updated Apr 28th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962757369 NPPES
Virginia Other P01130767 PTAN
Virginia MEDICAID 1962757369 PTAN
Virginia Other 261083931 PTAN

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