Provider Demographics
NPI:1326273400
Name:MOLINA, ISABEL S (LPN)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:S
Last Name:MOLINA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9217
Mailing Address - Country:US
Mailing Address - Phone:608-838-4095
Mailing Address - Fax:
Practice Address - Street 1:6024 MERRILL ST
Practice Address - Street 2:
Practice Address - City:MC FARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558-9217
Practice Address - Country:US
Practice Address - Phone:608-838-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI302672-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse