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NPI 1811659394

NPI 1811659394 : MOLLY ROLEN MSN, FNP-BC, CCRP : GERMANTOWN, TN

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General NPI Number Information
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    NPI Number           |    1811659394
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    Entity Type          |    Individual 
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    Provider Name        |    MOLLY ROLEN MSN, FNP-BC, CCRP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/12/2021
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    Last Update Date     |    08/07/2025
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Provider Practice Location Address
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    Address Line         |    8040 WOLF RIVER BLVD STE 102 
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    City                 |    GERMANTOWN
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    State                |    TN
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    Zip                  |    38138-1773
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    Country              |    US
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    Telephone            |    901-227-7900
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    Fax                  |    901-227-7920
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Provider Business Mailing Address
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    Address Line         |    350 N HUMPHREYS BLVD 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38120-2177
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    Country              |    US
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    Telephone            |    901-226-4003
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    Fax                  |    901-227-8591
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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        |    163WG0000X
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    Taxonomy Name        |    General Practice Registered Nurse
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    License Number       |    212006
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    31230
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    License Number State |    TN
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