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Individual

MOLLY ROBERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9880 ANGIES WAY STE 250, LOUISVILLE, KY 40241-2865
(502) 394-6341
(502) 394-6340
Mailing address
3605 NORTHGATE CT STE 204, NEW ALBANY, IN 47150-6422
(812) 207-2130
(812) 207-2140

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
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