| NPI | 1902414592 |
|---|---|
| Former Name | MOLLY NICOLE FAST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 117287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 117287) |
| 363L00000X Nurse Practitioner (Licence: OK 117287) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |