Provider Demographics
NPI:1336104702
Name:CAHILL, MOLLY L (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:L
Last Name:CAHILL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LOUISE
Other - Last Name:LILLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4320 WORNALL ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3255
Mailing Address - Country:US
Mailing Address - Phone:816-531-0552
Mailing Address - Fax:816-756-2503
Practice Address - Street 1:4320 WORNALL ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3255
Practice Address - Country:US
Practice Address - Phone:816-531-0552
Practice Address - Fax:816-756-2503
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO094759363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200372510AMedicaid
MOQ67884Medicare UPIN