Healthcare Provider Details

I. General information

NPI: 1588211486
Provider Name (Legal Business Name): MOLLY ELIZABETH QUINLAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2019
Last Update Date: 08/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E 14TH AVE
DENVER CO
80218-1903
US

IV. Provider business mailing address

1926 FOOTHILLS RD
GOLDEN CO
80401-1719
US

V. Phone/Fax

Practice location:
  • Phone: 303-832-5069
  • Fax:
Mailing address:
  • Phone: 303-585-1545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0994865-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: