Individual
KRISTEN M MOLLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(313) 473-1000
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004754
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12334362
CAQH
MI
Enumeration date
06/25/2006
Last updated
07/29/2022
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