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General NPI Number Information
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NPI Number | 1982546974
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Entity Type | Individual
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Provider Name | MOLLY ANN MCLAIN RN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 12567 5TH AVE N STE 100
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City | ZIMMERMAN
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State | MN
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Zip | 55398-8453
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Country | US
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Telephone | 763-856-9955
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Fax | 763-856-9956
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Provider Business Mailing Address
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Address Line | 12567 5TH AVE N STE 100
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City | ZIMMERMAN
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State | MN
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Zip | 55398-8453
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Country | US
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Telephone | 763-856-9955
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Fax | 763-856-9956
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 1698725
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License Number State | MN
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