Basic Information
Provider Information
NPI: 1053039339
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWLAND
FirstName: MOLLIE
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: CPNP
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 DICK LONAS RD UNIT 101
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091383
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber: 8655841363
Practice Location
Address1: 1341 BRANTON BLVD STE 102
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379228521
CountryCode: US
TelephoneNumber: 8656908778
FaxNumber: 8339082107
Other Information
ProviderEnumerationDate: 08/22/2022
LastUpdateDate: 08/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X32234TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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