Provider Demographics
NPI:1194250548
Name:MOLINAR, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MOLINAR
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 1:7007 WYOMING BLVD NE
Mailing Address - Street 2:C1
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3987
Mailing Address - Country:US
Mailing Address - Phone:505-828-3937
Mailing Address - Fax:505-715-5213
Practice Address - Street 1:7007 WYOMING BLVD NE
Practice Address - Street 2:C1
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3987
Practice Address - Country:US
Practice Address - Phone:505-828-3937
Practice Address - Fax:505-715-5213
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM688152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist