Healthcare Provider Details

I. General information

NPI: 1265455091
Provider Name (Legal Business Name): ANNA-LOUISE O MOLETTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 PRESIDENT PL SUITE 220
SMYRNA TN
37167-6844
US

IV. Provider business mailing address

216 DEER PARK DR
NASHVILLE TN
37205-3319
US

V. Phone/Fax

Practice location:
  • Phone: 615-459-3244
  • Fax: 615-459-6525
Mailing address:
  • Phone: 615-294-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD34231
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD34231
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: