Provider Demographics
NPI:1093787640
Name:TRIPP, MOLLIE FRANCES (DNP, RNC ,MSN ,NNP-)
Entity Type:Individual
Prefix:DR
First Name:MOLLIE
Middle Name:FRANCES
Last Name:TRIPP
Suffix:
Gender:F
Credentials:DNP, RNC ,MSN ,NNP-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 ROYAL TROON CT
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-8053
Mailing Address - Country:US
Mailing Address - Phone:252-561-6985
Mailing Address - Fax:
Practice Address - Street 1:1670 ST VINCENTS WAY
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8447
Practice Address - Country:US
Practice Address - Phone:904-602-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171842363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal