Healthcare Provider Details

I. General information

NPI: 1336104702
Provider Name (Legal Business Name): MOLLY L. CAHILL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY LOUISE LILLIS

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL ROAD SUITE 208
KANSAS CITY MO
64111-3255
US

IV. Provider business mailing address

4320 WORNALL ROAD SUITE 208
KANSAS CITY MO
64111-3255
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0552
  • Fax: 816-756-2503
Mailing address:
  • Phone: 816-531-0552
  • Fax: 816-756-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number094759
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number094759
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: