Provider Demographics
NPI:1760080071
Name:HANNA, MOLLY (MSN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:MSN, BSN
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:SILVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:158 BOTSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5809
Mailing Address - Country:US
Mailing Address - Phone:508-838-4483
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-384-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02453363L00000X
MARN2294943363L00000X
CT11460363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAPRN02453OtherSTATE OF RHODE ISLAND DEPARTMENT OF HEALTH