Provider Demographics
NPI:1528580529
Name:MOLLIE RIEFF, LLC
Entity Type:Organization
Organization Name:MOLLIE RIEFF, LLC
Other - Org Name:THE CENTERS FOR VULVOVAGINAL DISORDERS, SANTA FE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLIE
Authorized Official - Middle Name:FLINT
Authorized Official - Last Name:RIEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, WHNP-BC, MPH
Authorized Official - Phone:505-983-0405
Mailing Address - Street 1:1751 OLD PECOS TRL STE N
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4706
Mailing Address - Country:US
Mailing Address - Phone:505-983-0405
Mailing Address - Fax:505-983-6818
Practice Address - Street 1:1751 OLD PECOS TRL STE N
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4706
Practice Address - Country:US
Practice Address - Phone:505-983-0405
Practice Address - Fax:505-983-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02597363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty