Provider Demographics
NPI:1982403135
Name:NOVAK, MOLLY PATRICIA
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:PATRICIA
Last Name:NOVAK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 DIAMOND PKWY APT 6234
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4377
Mailing Address - Country:US
Mailing Address - Phone:614-323-3698
Mailing Address - Fax:
Practice Address - Street 1:1750 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1453
Practice Address - Country:US
Practice Address - Phone:614-323-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program