Healthcare Provider Details

I. General information

NPI: 1962183046
Provider Name (Legal Business Name): MOLLY ELIZABETH YEAGLEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY ELIZABETH CAVALLARO RN

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 08/15/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 DODGE ST
BEVERLY MA
01915-1711
US

IV. Provider business mailing address

81 HIGHLAND AVE
SALEM MA
01970-2768
US

V. Phone/Fax

Practice location:
  • Phone: 978-922-2171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2272617
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: