Provider Demographics
NPI:1093141855
Name:BROWN, MOLLY KATE (MSN, PMHNP-BC, FNP-B)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:KATE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, FNP-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6666 GUNPARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3396
Mailing Address - Country:US
Mailing Address - Phone:303-578-8085
Mailing Address - Fax:720-844-3298
Practice Address - Street 1:6666 GUNPARK DR STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3396
Practice Address - Country:US
Practice Address - Phone:303-578-8085
Practice Address - Fax:720-844-3298
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990831-FNP363LF0000X
COAPN.0990831-PMHNP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO66257573Medicaid