Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 056559 | MI |
NPI | 1023057684 |
---|---|
Provider Name | Elizabeth S Plemmons |
First Address | Ann Arbor, MI 48105-1598 |
Second Address | Wyandotte, MI 48192-4668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4098532 | (05) | MI |
4855010 | (05) | MI |
EP056559 | BC/BS (01) | MI |
F93592 | (02) | MI |