Individual
DR. MOLLY RAE AASBY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3900 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6398
(479) 966-4187
(479) 966-4179
Mailing address
3900 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6398
(479) 966-4187
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2017024394
MO
363LF0000X
Family Nurse Practitioner
Primary
219198
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
05
—
PENDING
—
MO
Enumeration date
08/04/2017
Last updated
07/21/2022
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