Healthcare Provider Details

I. General information

NPI: 1346914645
Provider Name (Legal Business Name): MOLLY LEIGHANNA SANDERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4335 MAYNARDVILLE HWY
MAYNARDVILLE TN
37807-3623
US

IV. Provider business mailing address

2424 EMORILAND BLVD
KNOXVILLE TN
37917-2306
US

V. Phone/Fax

Practice location:
  • Phone: 865-992-3867
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number214368
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: