Individual
MOLLY HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
833 CHESTNUT ST, SUITE 301, PHILADELPHIA, PA 19107-4414
(215) 955-7190
(215) 923-9186
Mailing address
833 CHESTNUT ST, SUITE 301, PHILADELPHIA, PA 19107-4414
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP013501
PA
363LG0600X
Gerontology Nurse Practitioner
SP013501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102925851
—
PA
Enumeration date
12/18/2013
Last updated
08/26/2014
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