MEDICARE: MS. ROBYN LEIGH HENLEY-MOLO NP

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	363LA2200X	Adult Health Nurse Practitioner	0024175730	VA

General Provider Information

NPI Number	:	1942718812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBYN LEIGH HENLEY-MOLO NP

Provider Business Mailing Address
First Line	:	7900 SHRADER RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23294-4215
Country	:	US
Telephone Number	:	804-288-1953
Fax Number	:

Provider Business Practice Location Address
First Line	:	13460 TREDEGAR LAKE PKWY
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-4070
Country	:	US
Telephone Number	:	804-288-1953
Fax Number	:

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

Provider Enumeration Date	:	01/13/2018
Last Update Date	:	02/04/2022

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