Organization
ADVANCED PRACTICE HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY KAY MOLINAR FNP-BC (FAMILY NURSE PRACTITIONER)
(719) 778-1414
Entity
Organization
Contact information
Practice address
1128 EAGLERIDGE BLVD, PUEBLO, CO 81008-2103
(719) 778-1414
Mailing address
378 KELSEY CT, FLORENCE, CO 81226-7509
(719) 371-8833
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
01/06/2020
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