Individual
MS. BRENDA LACEY MOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
146 S GRANITE ST, PRESCOTT, AZ 86303-4710
(928) 717-3276
(928) 717-3275
Mailing address
620 LESTER DR, PRESCOTT, AZ 86301-5371
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
AZ9203
AZ
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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