Healthcare Provider Details

I. General information

NPI: 1093846271
Provider Name (Legal Business Name): MOLLY KATHLEEN MCCAUGHEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY KATHLEEN POWELL PA-C

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 STANGE RD
AMES IA
50010-3914
US

IV. Provider business mailing address

1111 DUFF AVENUE MCFARLAND CLINIC, PC
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-956-4044
  • Fax: 515-956-4075
Mailing address:
  • Phone: 515-239-2155
  • Fax: 515-239-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001763
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: