Provider Demographics
NPI:1700350584
Name:MILLSAPS, MOLLY BEA (NP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BEA
Last Name:MILLSAPS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:BEA
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1699 E 1140 N
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-3017
Mailing Address - Country:US
Mailing Address - Phone:435-258-9070
Mailing Address - Fax:435-258-9080
Practice Address - Street 1:2311 W ROYAL PALM RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4916
Practice Address - Country:US
Practice Address - Phone:602-269-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4908452-4405363LP0808X
AZ221051363LP0808X
UT49084528900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health