MEDICARE: MOLLY MORTON SIPP FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	268633	MA

General Provider Information

NPI Number	:	1083715494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY MORTON SIPP FNP-C

Provider Business Mailing Address
First Line	:	3280 HOWELL MILL RD
Second Line	:	SUITE 342
City	:	ATLANTA
State	:	GA
Zip	:	30327
Country	:	US
Telephone Number	:	404-441-5464
Fax Number	:

Provider Business Practice Location Address
First Line	:	3280 HOWELL MILL RD NW STE 342
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4109
Country	:	US
Telephone Number	:	404-441-5464
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	10/17/2025

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