Individual
MARISA D MOLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP, CBIS
Contact information
Practice address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
(763) 581-9090
Mailing address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
(763) 581-9090
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP1645
MN
363L00000X
Nurse Practitioner
R 146976-3
MN
363LF0000X
Family Nurse Practitioner
Primary
R 146976-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255489500
—
MN
Enumeration date
07/26/2006
Last updated
08/09/2022
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