Provider Demographics
NPI:1609642198
Name:LUNSFORD, MOLLY LEE (CNM, WHNP-BC, RN)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:LEE
Last Name:LUNSFORD
Suffix:
Gender:F
Credentials:CNM, WHNP-BC, RN
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:LEE
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 E SHENNUM DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7718
Mailing Address - Country:US
Mailing Address - Phone:907-885-4595
Mailing Address - Fax:907-737-6784
Practice Address - Street 1:5000 E SHENNUM DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7718
Practice Address - Country:US
Practice Address - Phone:907-885-4595
Practice Address - Fax:907-737-6784
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK142445163W00000X
AK214433363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health