Provider Demographics
NPI:1184002453
Name:MOLLE, PATRICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MOLLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 BURNS RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4324
Mailing Address - Country:US
Mailing Address - Phone:561-626-1881
Mailing Address - Fax:
Practice Address - Street 1:3345 BURNS RD
Practice Address - Street 2:SUITE 206
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4324
Practice Address - Country:US
Practice Address - Phone:561-626-1881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2015-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9327109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily