Provider Demographics
NPI:1740949882
Name:JARRELS, MOLLY MARIE (PA-C)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:MARIE
Last Name:JARRELS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:MARIE
Other - Last Name:ANADALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:206-639-0089
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:563 NEFF AVE STE A
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3765
Practice Address - Country:US
Practice Address - Phone:540-434-1756
Practice Address - Fax:540-434-1840
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-16
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0110008356363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program