Provider Demographics
NPI:1659688604
Name:MOLLITT, ERIN E (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:MOLLITT
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5720
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32247-5720
Mailing Address - Country:US
Mailing Address - Phone:904-697-5650
Mailing Address - Fax:407-650-7578
Practice Address - Street 1:807 CHILDRENS WAY
Practice Address - Street 2:NEMOURS CHILDRENS CLINIC, JACKSONVILLE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8426
Practice Address - Country:US
Practice Address - Phone:904-697-3694
Practice Address - Fax:904-697-3927
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-10-13
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105618363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical