Healthcare Provider Details

I. General information

NPI: 1316836265
Provider Name (Legal Business Name): BLANCA ENA MOLINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 S 41ST TER
BELLEVUE NE
68147-1053
US

IV. Provider business mailing address

7322 S 41ST TER
BELLEVUE NE
68147-1053
US

V. Phone/Fax

Practice location:
  • Phone: 319-821-0101
  • Fax:
Mailing address:
  • Phone: 319-821-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: