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1740949882 NPI number — MOLLY MARIE JARRELS PA-C

NPI Number: 1740949882
Health Care Provider/Practitioner: MOLLY MARIE JARRELS PA-C

Information about “1740949882” NPI (MOLLY MARIE JARRELS PA-C) exists in 1740949882 in HTML format HTML  |  1740949882 in plain Text format TXT  |  1740949882 in PDF (Portable Document Format) PDF  |  1740949882 in an XML format XML  formats.

NPI Number : 1740949882 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740949882",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JARRELS",
    "FirstName": "MOLLY",
    "MiddleName": "MARIE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ANADALE",
    "OtherFirstName": "MOLLY",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "801 YORK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MANITOWOC",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54220-4630",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "206-639-0089",
    "MailingAddressFaxNumber": "920-684-1439",
    "FirstLinePracticeLocationAddress": "563 NEFF AVE STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARRISONBURG",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22801-3765",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "540-434-1756",
    "PracticeLocationAddressFaxNumber": "540-434-1840",
    "EnumerationDate": "12/16/2021",
    "LastUpdateDate": "07/01/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "0110008356",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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