Provider Demographics
NPI:1407190291
Name:ELLIOTT, MOLLY STEPHEN COWLEY (RN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:STEPHEN COWLEY
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:STEPHEN
Other - Last Name:COWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3686 GRANDVIEW PKWY
Mailing Address - Street 2:SUITE 820
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3407
Mailing Address - Country:US
Mailing Address - Phone:205-971-3000
Mailing Address - Fax:
Practice Address - Street 1:8000 LIBERTY PKWY STE 114
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35242-7563
Practice Address - Country:US
Practice Address - Phone:205-968-5988
Practice Address - Fax:205-968-5990
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-132166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily