Individual
MOLLY ROBERSON
Active
Individual
MOLLY ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002406A
IN LICENSE
IN
01
—
PA2333
KY LICENSE
KY
Enumeration date
02/06/2018
Last updated
07/25/2019
Update your record
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