Provider Demographics
NPI:1457166837
Name:STEVENS, MOLLY MCCARTER (MSN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MCCARTER
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:MCCARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4630 BRIGID CV
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-7417
Mailing Address - Country:US
Mailing Address - Phone:662-404-3276
Mailing Address - Fax:
Practice Address - Street 1:2028 W POPLAR AVE STE 112
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0618
Practice Address - Country:US
Practice Address - Phone:901-755-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38130363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health