MEDICARE: MOLLY ANN LOVEJOY PURCELL

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	163W00000X	Registered Nurse	2487215	MN

General Provider Information

NPI Number	:	1619803848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY ANN LOVEJOY PURCELL

Provider Business Mailing Address
First Line	:	13795 FLAGSTAFF AVE
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-3305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13795 FLAGSTAFF AVE
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-3305
Country	:	US
Telephone Number	:	651-210-1724
Fax Number	:

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

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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