Provider Demographics
NPI:1265961973
Name:MOLNAR, MEREDITH K (APRN)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:K
Last Name:MOLNAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:MOLNAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:2310 VILLAGE SQUARE PKWY STE 206
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-6351
Practice Address - Country:US
Practice Address - Phone:904-264-4405
Practice Address - Fax:904-391-5380
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN21042363L00000X
SC21042363L00000X
FLAPRN11018837363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health