Healthcare Provider Details

I. General information

NPI: 1174806012
Provider Name (Legal Business Name): MOLLY M LEHMANN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 24TH AVE S SUITE 700
MINNEAPOLIS MN
55454-1455
US

IV. Provider business mailing address

606 24TH AVE S SUITE 700
MINNEAPOLIS MN
55454-1455
US

V. Phone/Fax

Practice location:
  • Phone: 612-672-2450
  • Fax:
Mailing address:
  • Phone: 612-672-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR183645-1
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM0517
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: