Provider Demographics
NPI:1386396851
Name:FOX, MOLLY ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:FOX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:E
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 STEPHENS POINT RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-8633
Mailing Address - Country:US
Mailing Address - Phone:270-585-5142
Mailing Address - Fax:
Practice Address - Street 1:6330 QUADRANGLE DR STE 500
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8281
Practice Address - Country:US
Practice Address - Phone:888-849-7379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017340363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health