Provider Demographics
NPI:1639571110
Name:MOLL, KATY ZAHN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:ZAHN
Last Name:MOLL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:KATY
Other - Middle Name:KLAIRE
Other - Last Name:ZAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:113 CHRISTIAN LANE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458
Mailing Address - Country:US
Mailing Address - Phone:985-781-7353
Mailing Address - Fax:985-781-7354
Practice Address - Street 1:2545 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-781-7353
Practice Address - Fax:985-781-7354
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07985363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPA210078OtherPRESCRIPTIVE AUTHORITY
LACDS.045456-APNOtherCDS-APRN
MZ3310492OtherDEA