Individual
BRENDA JOYCE MOLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16480 WILLIAM FOSS RD, LA PINE, OR 97739-9486
(541) 536-8012
(541) 536-9873
Mailing address
PO BOX 126, LA PINE, OR 97739
(541) 536-8012
(541) 536-9873
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270016
—
OR
Enumeration date
11/15/2005
Last updated
10/18/2007
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