MEDICARE: MOLLY CHRISTENSEN APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9407152	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	406599	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9407152	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720557598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY CHRISTENSEN APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1495 S VOLUSIA AVE STE 203
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7047
Country	:	US
Telephone Number	:	386-218-6335
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 S VOLUSIA AVE STE 203
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7047
Country	:	US
Telephone Number	:	386-218-6335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2018
Last Update Date	:	05/27/2025

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Directions to “ MOLLY CHRISTENSEN APRN, PMHNP-BC” Practice Location

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