MRS. MOLLY SUSAN PHILLIPP C.R.N.P. NPI 1003925819

NPI Information

NPI: 1003925819
Provider Name: MRS. MOLLY SUSAN PHILLIPP, C.R.N.P.
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

Address:
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 522-0747
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MRS. Molly Susan Phillipp, C.R.N.P. is an obstetrics and gynecology nurse practitioner in Idaho Falls, ID. MRS. Molly Susan Phillipp, C.R.N.P. NPI is 1003925819. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404-042
Phone: (208) 522-0747
Fax: (208) 522-9641

The enumeration date for this NPI number is 8/29/2006 and was last updated on 5/10/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	NP320A	IDAHO	No
2	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	NP320A	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	820296824	OTHER	IDAHO	TAX ID NUMBER
2	S21767	MEDICARE UPIN	IDAHO
3	002352900	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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