Provider Demographics
NPI:1811509482
Name:POWELL, MOLLY ANNE (APRN)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:ANNE
Last Name:POWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:856-767-0077
Mailing Address - Fax:
Practice Address - Street 1:175 CROSS KEYS RD STE 300A
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-9263
Practice Address - Country:US
Practice Address - Phone:856-767-0077
Practice Address - Fax:888-248-8864
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR14373900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily