Provider Demographics
NPI:1558168674
Name:GREENWAY, MOLLY ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:GREENWAY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 RIVER WIND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-6094
Mailing Address - Country:US
Mailing Address - Phone:803-624-7341
Mailing Address - Fax:
Practice Address - Street 1:1348 WALTON WAY STE 4100
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-5107
Practice Address - Country:US
Practice Address - Phone:706-722-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP003180363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology