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General NPI Number Information
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NPI Number | 1720717549
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Entity Type | Individual
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Provider Name | MOLLY KATE CAVANAUGH CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 9263 MEDICAL PLAZA DR STE E
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City | CHARLESTON
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State | SC
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Zip | 29406-7112
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Country | US
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Telephone | 843-572-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 71 WARREN ST
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City | CHARLESTON
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State | SC
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Zip | 29403-6122
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Country | US
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Telephone | 434-960-9668
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 29035
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 111137
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License Number State | WV
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