Healthcare Provider Details

I. General information

NPI: 1720761414
Provider Name (Legal Business Name): MOLLY KIERNAN BARBIERI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 W 21ST ST
CLOVIS NM
88101-4149
US

IV. Provider business mailing address

912 W 21ST ST
CLOVIS NM
88101-4149
US

V. Phone/Fax

Practice location:
  • Phone: 575-935-9000
  • Fax: 575-935-1002
Mailing address:
  • Phone: 575-935-9000
  • Fax: 575-935-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberC-APN.0101090-C-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number79376
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number79376
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: