Provider Demographics
NPI:1033481403
Name:MOLLET, BRITTANY A (PA)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:A
Last Name:MOLLET
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1508 W 22ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1514
Mailing Address - Country:US
Mailing Address - Phone:605-328-3840
Mailing Address - Fax:605-328-3841
Practice Address - Street 1:1508 W 22ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1514
Practice Address - Country:US
Practice Address - Phone:605-328-3840
Practice Address - Fax:605-328-3841
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD0807363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant