Provider Demographics
NPI:1518392570
Name:PICKETT, MOLLY MELISSA (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:MELISSA
Last Name:PICKETT
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Gender:F
Credentials:AGPCNP-BC
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Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8018
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:2801 YOUNGFIELD ST
Practice Address - Street 2:SUITE 120
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2263
Practice Address - Country:US
Practice Address - Phone:720-898-9427
Practice Address - Fax:303-302-0808
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2017-02-16
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Provider Licenses
StateLicense IDTaxonomies
CO0990881363LA2200X, 363LG0600X
CO990881363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology