Basic Information
| Provider Information | |||||||||
| NPI: | 1073739215 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOLLOY-DALY | ||||||||
| FirstName: | NORA | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNM | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MOLLOY | ||||||||
| OtherFirstName: | NORA | ||||||||
| OtherMiddleName: | GERTRUDE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNM,ARNP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10710 CHARTER DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009677418 | ||||||||
| FaxNumber: | 6103723117 | ||||||||
| Practice Location | |||||||||
| Address1: | 10710 CHARTER DRIVE | ||||||||
| Address2: | STE 200 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108848000 | ||||||||
| FaxNumber: | 4107408587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 12/15/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | R101788 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 9236346 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 207V00000X | 9236346 | FL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | R101788 | MD | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 308345400 | 05 | FL | MEDICAID |