Provider Demographics
NPI:1760452791
Name:MOLLOY, BRIAN ARTHUR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ARTHUR
Last Name:MOLLOY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2130 POLY DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1625
Mailing Address - Country:US
Mailing Address - Phone:406-855-7000
Mailing Address - Fax:406-638-3535
Practice Address - Street 1:10110 SOUTH 7650 EAST
Practice Address - Street 2:
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022-0009
Practice Address - Country:US
Practice Address - Phone:406-638-3500
Practice Address - Fax:406-638-3535
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606769367500000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse