Molina, Brenda Joyce

Molina, Brenda Joyce is an sole proprietor health care provider with primary practice located at 16480 William Foss Rd , La Pine OR 97739-9486. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Molina, Brenda Joyce can be contacted via phone (541) 536-8012.

Contact Information

Primary practice address
16480 William Foss Rd La Pine OR 97739-9486
Phone: (541) 536-8012
Fax: (541) 536-9873
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X Oregon
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X Oregon
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X Oregon

Profile Details

NPI number 1215919436
LBN Legal business name Molina, Brenda Joyce
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2005
Last updated Oct 18th, 2007 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215919436 NPPES
Oregon MEDICAID 270016

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