Healthcare Provider Details

I. General information

NPI: 1962348292
Provider Name (Legal Business Name): MOLLY FRANZONELLO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 EVERGREEN LN STE 213
ANNANDALE VA
22003-3254
US

IV. Provider business mailing address

1486 POWELLS TAVERN PL
HERNDON VA
20170-2880
US

V. Phone/Fax

Practice location:
  • Phone: 703-642-7522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0024196735
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: