Molly Elizabeth Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP121093 Issued in ME

Practice address

111 Franklin Health CMNS
Farmington, ME 04938-6144

Phone

(207) 779-2628

Fax

(207) 779-2303

NPI assigned

Oct 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1811241706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FRANKLIN HEALTH CMNS",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386144",
            "telephone_number": "207-779-2628",
            "fax_number": "207-779-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FRANKLIN HEALTH CMNS",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386144",
            "telephone_number": "207-779-2628",
            "fax_number": "207-779-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MOLLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN57542",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP121093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth O Cho, M.D.
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• Christina C Christie, LCSW
• Scott D Christie, PSYD
• Gabriel Civiello, MD
• Clearwater Counseling & Consulting
• Alisa M Cleary, DO
• Kathryn Clement
• Steven R Coates, PA-C
• Susan E Cochran, MD

• Family Nurse Practitioner in Farmington, ME
• Providers in Farmington, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.