| Doctor Name: | MISS JESSICA LYNNE MOLLARD |
| NPI Number: | 1073829503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 587019 |
| Business Practice Address: | 12 Hillock Ct Glenville, NY - 123023735 |
| Business Phone Number: | 5183994368 |
| Business Fax Number: | |
| Mailing Address: | 12 Hillock Ct, GLENVILLE |
| State: | NY |
| Postal Code: | 123023735 |
| Phone Number: | 5183994368 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2010 |
| NPI Last Update Date: | 08/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | 587019 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |