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NPI Code Detail

MEDICARE: STACEY B MOLINERE F.N.P.

MEDICARE: STACEY B MOLINERE F.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP03857LA
2363LF0000XFamily Nurse PractitionerAP03857LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992743892
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY B MOLINERE F.N.P.
Provider Business Mailing Address
First Line : 2000 OPELOUSAS ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-2641
Country : US
Telephone Number : 337-439-9983
Fax Number : 337-497-2556
Provider Business Practice Location Address
First Line : 2000 OPELOUSAS ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-2641
Country : US
Telephone Number : 337-439-9983
Fax Number : 337-497-2556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 03/27/2025

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