Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 5004250 | NC |
NPI | 1003051418 |
---|---|
Provider Name | Miss Molly Jean Crossman |
First Address | Sanford, NC 27330-4161 |
Second Address | Sanford, NC 27330-4161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 29/03/2017 |