Provider Demographics
NPI:1073739215
Name:MOLLOY-DALY, NORA G (CNM)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:G
Last Name:MOLLOY-DALY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:GERTRUDE
Other - Last Name:MOLLOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM,ARNP
Mailing Address - Street 1:10710 CHARTER DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2858
Mailing Address - Country:US
Mailing Address - Phone:800-967-7418
Mailing Address - Fax:610-372-3117
Practice Address - Street 1:10710 CHARTER DRIVE
Practice Address - Street 2:STE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2858
Practice Address - Country:US
Practice Address - Phone:410-884-8000
Practice Address - Fax:410-740-8587
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR101788367A00000X, 207V00000X
FL9236346367A00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308345400Medicaid
AG426ZMedicare PIN