Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 18115 | TN |
NPI | 1033104070 |
---|---|
Provider Name | Dr. Molly Rheney |
First Address | Jackson, TN 38301-3948 |
Second Address | Jackson, TN 38301-3948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3033637 | (05) | TN |
4468525 | AETNA (01) | TN |
6190387 | CIGNA (01) | TN |
744555 | 1ST HEALTH (01) | TN |
A99727 | (02) | TN |