Individual provider Active NPI

Patricia Thelma Molla, APRN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Perry Point, MD
National Provider Identifier
1417030305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
LE-0000138 Issued in DE
Practice address
Vamhcs, Perry Point Division
Building 366, Room 140
Perry Point, MD 21902
Phone
(800) 949-1003
Fax
(410) 642-2411
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X LE-0000138 DE Primary

Addresses

Primary practice location

Vamhcs, Perry Point Division
Building 366, Room 140
Perry Point, MD 21902

Mailing address

425 Flintville Rd
Delta, PA 17314-8537
Phone (410) 642-2411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LE-0000138DEMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417030305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FLINTVILLE RD",
            "city": "DELTA",
            "state": "PA",
            "postal_code": "173148537",
            "telephone_number": "410-642-2411",
            "fax_number": "410-642-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VAMHCS, PERRY POINT DIVISION",
            "address_2": "BUILDING 366, ROOM 140",
            "city": "PERRY POINT",
            "state": "MD",
            "postal_code": "21902",
            "telephone_number": "800-949-1003",
            "fax_number": "410-642-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLA",
        "first_name": "PATRICIA",
        "middle_name": "THELMA",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "DE",
            "license": "LE-0000138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry Point, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.