| Doctor Name: | MRS. MOLLY SUSAN PHILLIPP |
| NPI Number: | 1003925819 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.R.N.P. |
| License Number: | NP320A |
| Business Practice Address: | 2065 E 17th St Suite D Idaho Falls, ID - 834048042 |
| Business Phone Number: | 2085220747 |
| Business Fax Number: | 2085229641 |
| Mailing Address: | 2065 E 17th St, Suite D IDAHO FALLS |
| State: | ID |
| Postal Code: | 834048042 |
| Phone Number: | 2085220747 |
| Fax Number: | 2085229641 |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 05/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | NP320A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |