Healthcare Provider Details

I. General information

NPI: 1316654825
Provider Name (Legal Business Name): MOLLY MCNEELY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S CENTRAL AVE STE 700
MARSHFIELD WI
54449-4138
US

IV. Provider business mailing address

1307 N SAINT JOSEPH AVE
MARSHFIELD WI
54449-1340
US

V. Phone/Fax

Practice location:
  • Phone: 715-221-5751
  • Fax:
Mailing address:
  • Phone: 715-898-6208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13382
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: