Provider Demographics
NPI:1356943799
Name:SALMONSEN, MOLLY LYNN (NP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:LYNN
Last Name:SALMONSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:LYNN
Other - Last Name:ARCHIBALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 6TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531-2524
Mailing Address - Country:US
Mailing Address - Phone:641-799-9947
Mailing Address - Fax:
Practice Address - Street 1:101 CABARRUS AVE E
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3699
Practice Address - Country:US
Practice Address - Phone:855-743-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013778363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner