Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R112938 | MD |
NPI | 1013225465 |
---|---|
Provider Name | Molly Foote Carr |
First Address | Glen Echo, MD 20812-9998 |
Second Address | Gaithersburg, MD 20877-2458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 25/10/2017 |