Provider Demographics
NPI:1104985043
Name:WALKER, MOLLY VIRGINIA (RN, CNM, MSN)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:VIRGINIA
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN, CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:12 PAULETTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8149
Mailing Address - Country:US
Mailing Address - Phone:732-462-8139
Mailing Address - Fax:732-303-6009
Practice Address - Street 1:HORIZON HEALTH CENTER
Practice Address - Street 2:714 BERGEN AVENUE
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-451-6300
Practice Address - Fax:201-451-0619
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR005762600163W00000X
NJ25ME00014001367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse