Provider Demographics
NPI:1790192243
Name:MCMILLION, MOLLY SCARBOROUGH (RN, BSN, IBCLC, CCE)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:SCARBOROUGH
Last Name:MCMILLION
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC, CCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-8952
Mailing Address - Country:US
Mailing Address - Phone:304-667-4362
Mailing Address - Fax:
Practice Address - Street 1:107 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-8952
Practice Address - Country:US
Practice Address - Phone:304-667-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV61869163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant