Individual
MS. CORNELIA R. MOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3793
(904) 390-3792
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP-1542962
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP-1542962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000918387A
—
GA
05
—
301994200
—
FL
Enumeration date
08/10/2006
Last updated
10/20/2011
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