Provider Demographics
NPI:1861668436
Name:ALLEN, MOLLY PATRICIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:PATRICIA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:PATRICIA
Other - Last Name:KRAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:352 N ROSS ST
Mailing Address - Street 2:PO BOX 458
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612-8165
Mailing Address - Country:US
Mailing Address - Phone:989-435-7727
Mailing Address - Fax:
Practice Address - Street 1:352 N ROSS ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8165
Practice Address - Country:US
Practice Address - Phone:989-435-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist