MEDICARE: MOLLY KATHLEEN ORR

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	363L00000X	Nurse Practitioner	2022007242	MO

General Provider Information

NPI Number	:	1164132700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY KATHLEEN ORR

Provider Business Mailing Address
First Line	:	5649 MURDOCH AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2868
Country	:	US
Telephone Number	:	314-221-3545
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 PARK AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2514
Country	:	US
Telephone Number	:	314-577-5609
Fax Number	:

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

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	10/16/2023

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