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General NPI Number Information
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NPI Number | 1972068070
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Entity Type | Organization
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Legal Business Name | MISTY MOLINA, ARNP
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 6002 WESTGATEBLVD., STE 120
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City | TACOMA
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State | WA
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Zip | 98406
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Country | US
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Telephone | 253-376-9070
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Fax | 253-248-0149
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Provider Business Mailing Address
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Address Line | PO BOX 734
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City | FOX ISLAND
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State | WA
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Zip | 98333
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Country | US
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Telephone | 253-376-9070
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Fax | 253-248-0149
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MISTY M MOLINA
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Credential | ARNP, CNM, WHNP
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Telephone | 253-376-9070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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