Provider Demographics
NPI:1356803126
Name:MOLIERE, BISSONNE (FNP)
Entity type:Individual
Prefix:
First Name:BISSONNE
Middle Name:
Last Name:MOLIERE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:844-735-1418
Mailing Address - Fax:855-737-5542
Practice Address - Street 1:117 E COLORADO BLVD STE 600
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3712
Practice Address - Country:US
Practice Address - Phone:844-735-1418
Practice Address - Fax:855-737-5542
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily