Provider Demographics
NPI:1013725563
Name:MOLINA, BRIONNE NICOLE
Entity type:Individual
Prefix:
First Name:BRIONNE
Middle Name:NICOLE
Last Name:MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 ROCKLEDGE CT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2229
Mailing Address - Country:US
Mailing Address - Phone:734-717-1984
Mailing Address - Fax:
Practice Address - Street 1:1536 ROCKLEDGE CT
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2229
Practice Address - Country:US
Practice Address - Phone:734-717-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula