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General NPI Number Information
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NPI Number | 1598659716
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Entity Type | Individual
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Provider Name | MOLLY SHIRYL MRAZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 5801 BREMO RD
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City | RICHMOND
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State | VA
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Zip | 23226-1907
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Country | US
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Telephone | 804-285-2011
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Fax |
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Provider Business Mailing Address
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Address Line | 5190 JASON DR
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City | ERIE
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State | PA
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Zip | 16506-6050
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Country | US
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Telephone | 814-969-9395
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110011022
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License Number State | VA
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