Healthcare Provider Details

I. General information

NPI: 1558797399
Provider Name (Legal Business Name): MOLLIE ELIZABETH TOLAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 TUSCULUM BLVD
GREENEVILLE TN
37745-4279
US

IV. Provider business mailing address

1021 W OAKLAND AVE STE 310
JOHNSON CITY TN
37604-2192
US

V. Phone/Fax

Practice location:
  • Phone: 423-783-5560
  • Fax: 423-783-5563
Mailing address:
  • Phone: 423-952-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number17727
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number17727
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number881
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17727
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: