Provider Demographics
NPI:1699239129
Name:VALENTE, MOLLY MACKAY (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MACKAY
Last Name:VALENTE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:R
Other - Last Name:MACKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 CORPORATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1966
Mailing Address - Country:US
Mailing Address - Phone:781-826-8065
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST STE 414
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1889
Practice Address - Country:US
Practice Address - Phone:781-952-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2279335363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care