Basic Information
| Provider Information | |||||||||
| NPI: | 1033464508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | BAILEY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 971 TOMMY MUNRO DR | ||||||||
| Address2: | |||||||||
| City: | BILOXI | ||||||||
| State: | MS | ||||||||
| PostalCode: | 395322137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2283927760 | ||||||||
| FaxNumber: | 2283927646 | ||||||||
| Practice Location | |||||||||
| Address1: | 971 TOMMY MUNRO DR STE C | ||||||||
| Address2: | |||||||||
| City: | BILOXI | ||||||||
| State: | MS | ||||||||
| PostalCode: | 395322137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2283927760 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2012 | ||||||||
| LastUpdateDate: | 09/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R873896 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.