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NPI Code Detail

MEDICARE: MOLLY JOBE CNM

MEDICARE: MOLLY JOBE CNM
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
1163W00000XRegistered NurseRN252059GA
2367A00000XAdvanced Practice MidwifeRN252059GA

General Provider Information

NPI Number : 1417493388
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY JOBE CNM
Provider Business Mailing Address
First Line : 2000 CAMBRIDGE AVE
Second Line :
City : ATLANTA
State : GA
Zip : 30337-1816
Country : US
Telephone Number : 256-468-8746
Fax Number :
Provider Business Practice Location Address
First Line : 4625 LINDELL BLVD FL 2
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3739
Country : US
Telephone Number : 914-919-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2017
Last Update Date : 11/17/2025

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Directions to “ MOLLY JOBE CNM” Practice Location

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