Individual
EILEEN MOLYET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
421 SE ALFRED MARKHAM ST, LAKE CITY, FL 32025-2204
(386) 697-1364
(888) 370-3379
Mailing address
421 SE ALFRED MARKHAM ST, LAKE CITY, FL 32025-2204
(386) 697-1364
(888) 370-3379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1257132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305412800
—
FL
01
—
G0073
BLUE SHIELD PROV #
FL
Enumeration date
09/09/2005
Last updated
02/03/2015
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