Provider Demographics
NPI:1194524983
Name:SUTHERLAND, MOLLY KATHERINE (FNP-C, ATC)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:KATHERINE
Last Name:SUTHERLAND
Suffix:
Gender:
Credentials:FNP-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HARDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-2924
Mailing Address - Country:US
Mailing Address - Phone:434-610-4413
Mailing Address - Fax:
Practice Address - Street 1:55 COMFORT WAY STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3788
Practice Address - Country:US
Practice Address - Phone:540-463-3381
Practice Address - Fax:540-463-3477
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024191944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily