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General NPI Number Information
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NPI Number | 1376265819
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Entity Type | Individual
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Provider Name | EMILY MOLLER RN, NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 105 BERTHA RD STE B
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City | TAOS
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State | NM
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Zip | 87571-7148
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Country | US
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Telephone | 575-758-4297
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Fax | 575-751-7237
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | ARROYO SECO
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State | NM
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Zip | 87514-0144
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Country | US
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Telephone | 203-297-3360
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 814786
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License Number State | NV
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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 | RN95192614
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95021947
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 77964
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License Number State | NM
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