Individual
MOLLY MAE SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2020 PROXIMITY DR APT 508, CHARLESTON, SC 29414-7941
(540) 421-4437
Mailing address
2020 PROXIMITY DR APT 508, CHARLESTON, SC 29414-7941
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
0001273709
VA
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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