Provider Demographics
NPI:1104203090
Name:MOLEINS, DAWN MICHELLE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:MOLEINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-0070
Mailing Address - Country:US
Mailing Address - Phone:609-265-1700
Mailing Address - Fax:609-265-8146
Practice Address - Street 1:693 MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-5043
Practice Address - Country:US
Practice Address - Phone:609-265-1700
Practice Address - Fax:609-265-8146
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00564300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner