Basic Information
| Provider Information | |||||||||
| NPI: | 1114492964 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHREIBER | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2695 ROCKY MOUNTAIN AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805389071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706244034 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16222 W US HIGHWAY 24 STE 200 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808638763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196860878 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2018 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | PA.0005592 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.