Provider Demographics
NPI:1255326872
Name:MOLL, CORINNE NADINE (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:NADINE
Last Name:MOLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NICOLLET MALL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402
Mailing Address - Country:US
Mailing Address - Phone:612-333-2503
Mailing Address - Fax:612-333-7080
Practice Address - Street 1:801 NICOLLET MALL SUITE 400
Practice Address - Street 2:JOHN A HAUGEN ASSOCIATES PA
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402
Practice Address - Country:US
Practice Address - Phone:612-333-2503
Practice Address - Fax:612-333-7080
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45264207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2432783OtherAMERICA'S PPO
MN265P9MOOtherBLUE CROSS BLUE SHIELD
MNHP60855OtherHEALTH PARTNERS
WI34834900Medicaid
MNFP9041046550OtherPREFERRED ONE
MN0704755OtherMEDICA CHOICE
MN0700065OtherMEDICA DUAL/MEDICARE MA
MN182801OtherU-CARE
MN185156000Medicaid
I11974Medicare UPIN
WI34834900Medicaid