Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN.417166 | OH |
NPI | 1003461351 |
---|---|
Provider Name | Kelly Plonski |
First Address | Parma, OH 44134-5347 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2019 |
Last Update Date | 22/03/2021 |