MOLLY JEAN PAULSON PAC NPI 1558578641

NPI Information

NPI: 1558578641
Provider Name: MOLLY JEAN PAULSON, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
2849 MICHIGAN ST NE
SUITE 102
GRAND RAPIDS, MI
ZIP 49506
Phone: (616) 285-6450
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Molly Jean Paulson, PAC is a medical physician assistant in Grand Rapids, MI. Molly Jean Paulson, PAC NPI is 1558578641. 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:

2849 MICHIGAN ST NE
SUITE 102
GRAND RAPIDS, MI
ZIP 49506-216
Phone: (616) 285-6450
Fax: (616) 285-6455

The enumeration date for this NPI number is 5/17/2007 and was last updated on 7/8/2007.

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	363AM0700X	Physician Assistant	Medical	5601003048	MICHIGAN	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	MP0852651	OTHER		DEA CONT SUB CERTIFICATE
2	5601003048	OTHER	MICHIGAN	PHYSICIAN ASSISTANT LICEN

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: 11/14/2023

NPI Synchronization or Removal

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