Provider Demographics
NPI:1215688700
Name:MCGIRT, MOLLY MADISON (BSN DNP PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MADISON
Last Name:MCGIRT
Suffix:
Gender:F
Credentials:BSN DNP PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 PARK SOUTH STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-4479
Mailing Address - Country:US
Mailing Address - Phone:704-654-6245
Mailing Address - Fax:
Practice Address - Street 1:4412 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3130
Practice Address - Country:US
Practice Address - Phone:980-581-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMCGI-JZBXP363L00000X
NC5015652363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner