Mason, Molly

Mason, Molly is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142-7884. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mason, Molly can be contacted via phone (629) 485-6002.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142-7884
Phone: (629) 485-6002
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 11725 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 652566-1 New York

Profile Details

NPI number 1902177876
LBN Legal business name Mason, Molly
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2012
Last updated Jul 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902177876 NPPES
Wisconsin MEDICAID 100200133

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