Provider Demographics
NPI:1386175511
Name:KIRKLAND, MOLLY ELIZABETH
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LEDGESTONE DR
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1456
Mailing Address - Country:US
Mailing Address - Phone:304-483-7774
Mailing Address - Fax:
Practice Address - Street 1:1249 15TH ST STE 4000
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3663
Practice Address - Country:US
Practice Address - Phone:304-691-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV86225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily