Individual
MOLLIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5875 BREMO RD, SUITE104, RICHMOND, VA 23226-1930
(804) 287-7770
(804) 287-7801
Mailing address
5875 BREMO RD, SUITE104, RICHMOND, VA 23226-1930
(804) 287-7770
(804) 287-7801
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024059551
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144323577
—
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
09/07/2006
Last updated
05/07/2010
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