Individual
MOLLY ANNE MOORE-PULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
802 AINSWORTH DR STE A, PRESCOTT, AZ 86301-1623
(928) 445-6025
(928) 777-2423
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5874
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN049339
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z214401
MEDICARE INDIVIDUAL PTAN
AZ
Enumeration date
10/14/2005
Last updated
11/10/2020
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