Provider Demographics
NPI:1285464867
Name:SASSER, MOLLY GRACE READY (NP-C)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:GRACE READY
Last Name:SASSER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 JEFFERSON STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MS
Mailing Address - Zip Code:39654
Mailing Address - Country:US
Mailing Address - Phone:601-587-4304
Mailing Address - Fax:601-587-4515
Practice Address - Street 1:149 JEFFERSON STREET SOUTH
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MS
Practice Address - Zip Code:39654
Practice Address - Country:US
Practice Address - Phone:601-587-4304
Practice Address - Fax:601-587-4515
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906732363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner