Provider Demographics
NPI:1245711555
Name:CASEY, MOLLY CATES (CRNP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:CATES
Last Name:CASEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:CATES
Other - Last Name:HACKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 N POINTE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4132
Mailing Address - Country:US
Mailing Address - Phone:717-560-6444
Mailing Address - Fax:717-569-1044
Practice Address - Street 1:190 N POINTE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-560-6444
Practice Address - Fax:717-569-1044
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily