Provider Demographics
NPI:1285090902
Name:MOLL, JOCELYN
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:MOLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6116 E ARBOR AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-6103
Mailing Address - Country:US
Mailing Address - Phone:480-219-1010
Mailing Address - Fax:480-219-1771
Practice Address - Street 1:6116 E ARBOR AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-6107
Practice Address - Country:US
Practice Address - Phone:480-219-1010
Practice Address - Fax:480-219-1771
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ265875363L00000X
CA95010975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner