Provider Demographics
NPI:1487941803
Name:STUDER, MOLLY EILEEN STAPLETON (PA-C)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:EILEEN STAPLETON
Last Name:STUDER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:651-495-6600
Mailing Address - Fax:952-883-9677
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-495-6600
Practice Address - Fax:952-883-9677
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2020-02-20
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Provider Licenses
StateLicense IDTaxonomies
MN10986363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant