Provider Demographics
NPI:1518792340
Name:BRECHT, MOLLY BETH
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BETH
Last Name:BRECHT
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 1:13435 UNIVERSITY AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8251
Mailing Address - Country:US
Mailing Address - Phone:515-225-7132
Mailing Address - Fax:
Practice Address - Street 1:13435 UNIVERSITY AVE STE 500
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8251
Practice Address - Country:US
Practice Address - Phone:515-225-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAG08240106363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care