Provider Demographics
NPI:1982942132
Name:MEANS, MOLLY E (PA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:E
Last Name:MEANS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:HOLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7124 COMMONS DR C
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-2620
Mailing Address - Country:US
Mailing Address - Phone:307-426-4060
Mailing Address - Fax:307-426-4061
Practice Address - Street 1:7124 COMMONS DR C
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-2620
Practice Address - Country:US
Practice Address - Phone:307-426-4060
Practice Address - Fax:307-426-4061
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant