Provider Demographics
NPI:1316836265
Name:MOLINA, BLANCA ENA
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:ENA
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 1:7322 S 41ST TER
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-1053
Mailing Address - Country:US
Mailing Address - Phone:319-821-0101
Mailing Address - Fax:
Practice Address - Street 1:7322 S 41ST TER
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68147-1053
Practice Address - Country:US
Practice Address - Phone:319-821-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No385H00000XRespite Care FacilityRespite Care