Brenda Lacey Moles, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

AZ9203 Issued in AZ

Practice address

146 S Granite St
Prescott, AZ 86303-4710

Phone

(928) 717-3276

Fax

(928) 717-3275

NPI assigned

Sep 28, 2009

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 28, 2009.

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1821322504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 LESTER DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 S GRANITE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034710",
            "telephone_number": "928-717-3276",
            "fax_number": "928-717-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLES",
        "first_name": "BRENDA",
        "middle_name": "LACEY",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "AZ9203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell L Gelber Edd PC
• Shawn Jeffery Mitchell, APRN
• Ted A. Mize I, P.T.
• Daniel Lee Moffat, P.A.C.
• Florin Victor Moisiuc, M.D.
• Mary-Lou Molloy, P.T.
• Debra M Molter, OTR/L
• Alison Momjian, BSN,RN
• Pierre N Momjian, D.P.M.
• Thomas Edward Monachino, MD

• All providers in Prescott, AZ
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.