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General NPI Number Information
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NPI Number | 1346714243
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Entity Type | Individual
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Provider Name | MOLLEY EAGLE CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 7419 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1167
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Country | US
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Telephone | 256-400-4210
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Fax | 256-400-5665
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Provider Business Mailing Address
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Address Line | 7419 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1167
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Country | US
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Telephone | 256-400-4210
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Fax | 256-400-5665
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-146309
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-146309
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License Number State | AL
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