Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036-128001 | IL |
N | 207VG0400X | Gynecologist | A106453 | CA |
N | 207VX0000X | Obstetrician | A106453 | CA |
NPI | 1033412531 |
---|---|
Provider Name | Jamie Lynn Plett |
First Address | Rockford, IL 61107-6637 |
Second Address | Rockford, IL 61107-6637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2010 |
Last Update Date | 10/11/2016 |