Provider Demographics
NPI:1316810575
Name:GULINO, MOLLIE JO (WHNP, DNP)
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:JO
Last Name:GULINO
Suffix:
Gender:F
Credentials:WHNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2327
Mailing Address - Country:US
Mailing Address - Phone:469-321-5998
Mailing Address - Fax:
Practice Address - Street 1:1012 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2327
Practice Address - Country:US
Practice Address - Phone:469-321-5998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104825592363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health