Healthcare Provider Details

I. General information

NPI: 1639238652
Provider Name (Legal Business Name): MOLLY K ROTHMEYER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 482 BOX 2480
FPO AP
96362-0025
US

IV. Provider business mailing address

PO BOX 5104
JBER AK
99505-0104
US

V. Phone/Fax

Practice location:
  • Phone: 253-964-2096
  • Fax:
Mailing address:
  • Phone: 253-683-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNURU1458
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberNURU1458
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-3836
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007292
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberAPRN-3836
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: