Provider Demographics
NPI:1982938957
Name:MOLLOY, PATRICIA A (RN, PMHCNS, BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:RN, PMHCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 APPIAN WAY
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2502
Mailing Address - Country:US
Mailing Address - Phone:401-456-9704
Mailing Address - Fax:
Practice Address - Street 1:520 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2532
Practice Address - Country:US
Practice Address - Phone:401-528-0193
Practice Address - Fax:401-528-0124
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPNS00007364SP0807X
RIRN 25303163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No163W00000XNursing Service ProvidersRegistered Nurse