Individual
JOHN M. MOLLINEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2245 WINCHESTER AVE, ASHLAND, KY 41101-7848
(606) 408-2600
(606) 408-2605
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
(606) 408-4000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006897
KY
363LF0000X
Family Nurse Practitioner
59306
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3131266
—
OH
05
—
3810020137
—
WV
05
—
7100159060
—
KY
Enumeration date
09/13/2010
Last updated
03/20/2012
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