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General NPI Number Information
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NPI Number | 1346692001
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Entity Type | Individual
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Provider Name | MOLLY FURLONG
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Gender | Female
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 134 MAIN STREET
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City | HOKAH
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State | MN
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Zip | 55941-6501
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Country | US
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Telephone | 507-951-9873
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Fax |
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Provider Business Mailing Address
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Address Line | 134 MAIN STREET
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City | HOKAH
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State | MN
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Zip | 55941
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 315240
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License Number State | WI
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