Provider Demographics
NPI:1477914190
Name:MOLLOY, JESSICA CHRISTENSON (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:CHRISTENSON
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:CHRISTENSEN
Other - Last Name:KRUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:5656 BEE CAVES RD SUITE E-200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-327-8700
Mailing Address - Fax:512-327-8701
Practice Address - Street 1:5656 BEE CAVES RD SUITE E-200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-327-8700
Practice Address - Fax:512-327-8701
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner