Healthcare Provider Details
I. General information
NPI: 1568019826
Provider Name (Legal Business Name): MICHELLE RENEE MOLINA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/21/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
115 MALL DR
HANFORD CA
93230-5786
US
IV. Provider business mailing address
435 HELENE ST
LEMOORE CA
93245-9133
US
V. Phone/Fax
- Phone: 559-537-1160
- Fax: 559-537-1169
- Phone: 559-816-3914
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95013329 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: