Provider Demographics
NPI:1770792608
Name:MOLLOY, ANNE ELIZABETH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TUMBLE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5651
Mailing Address - Country:US
Mailing Address - Phone:603-488-1859
Mailing Address - Fax:
Practice Address - Street 1:20 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6743
Practice Address - Country:US
Practice Address - Phone:603-663-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0509862303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNP407101Medicare PIN