Molly Mae Anderson, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Detroit Lakes, MN
NPI 1881454064 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1881454064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 11407 (MN)
- Practice address
- 1027 Washington Ave
Detroit Lakes, MN 56501-3409 - Phone
- (218) 847-5611
- NPI assigned
- Mar 22, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Marys Regional Health Center
Practice addresses (Care Compare)
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 847-5611
Hospital & facility affiliations
- Essentia Health St Marys - Detroit Lakes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240430001128 | MN | Practitioner - Nurse Practitioner | 3476993056 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Marys Regional Health Center | Current | Accepting new patients | |
| St. Mary'S Regional Health Center | Current |
Accepting new patients | |
| St Mary'S Regional Health Center | Current |
Accepting new patients |
Locations
1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11407 | MN | Yes |
Addresses
Primary practice location
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Mailing address
37918 State Highway 87
Frazee, MN 56544-9406
Phone (701) 936-4357
Other providers in Detroit Lakes, MN
- Elizabeth Niewojna Amaya
- Mary Lindstrom Amundson
- Lauren Anderson
- Lori Kathryn Anderson
- Maren Nicole Anderson
- Molly Marie Anderson
- Roberta Arvidson
- Austin Askelson
- Heather Bachmann-Campbell
- Cindy Sue Bailey
All providers in Detroit Lakes, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.