Piccono, Molly C
Piccono, Molly C is an individual health care provider with primary practice located at 6140 W Curtisian Ave Suite 100, Boise ID 83704-0109. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Piccono, Molly C can be contacted via phone (208) 367-7090.Contact Information
Primary practice address
6140 W Curtisian Ave Suite 100
Boise ID 83704-0109
Phone: (208) 367-7090
Fax: (208) 367-7092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA659 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA-659 | Idaho |
Profile Details
| NPI number | 1881739274 |
|---|---|
| LBN Legal business name | Piccono, Molly C |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Dec 5th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881739274 | NPPES |
| Idaho | MEDICAID | 8076996 | |
| Idaho | Other | P00395077 |
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