| Doctor Name: | MARK A MOLLNER |
| NPI Number: | 1417949447 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | 24151992 |
| Business Practice Address: | 576 Jefferson Ave Mcdonald Army Health Center- Family Health Clinic Fort Eustis, VA - 236041602 |
| Business Phone Number: | 7573147613 |
| Business Fax Number: | |
| Mailing Address: | 576 Jefferson Ave, Mcdonald Army Health Center- Family Health Clinic FORT EUSTIS |
| State: | VA |
| Postal Code: | 236041602 |
| Phone Number: | 7573147613 |
| Fax Number: | |
| NPI Enumeration Date: | 08/16/2005 |
| NPI Last Update Date: | 10/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 24151992 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |