Phillipp, Molly Susan

Phillipp, Molly Susan is an individual health care provider with primary practice located at 2065 E 17Th St Suite D, Idaho Falls ID 83404-8042. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Phillipp, Molly Susan can be contacted via phone (208) 522-0747.

Contact Information

Primary practice address
2065 E 17Th St Suite D Idaho Falls ID 83404-8042
Phone: (208) 522-0747
Fax: (208) 522-9641
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X NP320A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X NP320A Idaho

Profile Details

NPI number 1003925819
LBN Legal business name Phillipp, Molly Susan
Credentials C.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated May 10th, 2013 - about 13 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 1003925819 NPPES
Idaho MEDICAID 002352900

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