Provider Demographics
NPI:1356156988
Name:HUEY, MOLLY LONG (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:LONG
Last Name:HUEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANNE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:402 WHITE MOUNTAIN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-5813
Mailing Address - Country:US
Mailing Address - Phone:575-937-3417
Mailing Address - Fax:575-286-0365
Practice Address - Street 1:708 MECHEM DR STE B
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6952
Practice Address - Country:US
Practice Address - Phone:575-215-3100
Practice Address - Fax:575-286-0365
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily