Healthcare Provider Details

I. General information

NPI: 1265357545
Provider Name (Legal Business Name): MOLLY ANN ARMENTROUT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1873
US

IV. Provider business mailing address

3002 VALE DR
DAYTON OH
45420-3921
US

V. Phone/Fax

Practice location:
  • Phone: 844-231-9715
  • Fax:
Mailing address:
  • Phone: 937-974-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: