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Individual

MRS. MOLLY DEIDRE COLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2300 E 6TH AVE, FLAGSTAFF, AZ 86004-4247
(928) 773-4082
(928) 773-4086
Mailing address
2625 N EDDY DR, FLAGSTAFF, AZ 86001-1018
(928) 774-1430

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN137802
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130600
AZ
01
RN137802
RN LICENSE
AZ
Enumeration date
04/10/2007
Last updated
07/08/2007
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