Provider Demographics
NPI:1508201963
Name:MOLSTAD, JESSICA MARY (NP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARY
Last Name:MOLSTAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11111 NALL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1625
Mailing Address - Country:US
Mailing Address - Phone:913-302-7183
Mailing Address - Fax:888-779-3217
Practice Address - Street 1:11111 NALL AVE STE 103
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1625
Practice Address - Country:US
Practice Address - Phone:913-302-7183
Practice Address - Fax:888-779-3217
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013006422363LF0000X
KS5375975081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily