Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01082145A | IN |
N | 207X00000X | Orthopaedic Surgeon | 2014018118 | MO |
N | 207X00000X | Orthopaedic Surgeon | 60863 | TN |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 60863 | TN |
NPI | 1245644228 |
---|---|
Provider Name | Kristen Lynn Ploetze |
First Address | Knoxville, TN 37922-3355 |
Second Address | Knoxville, TN 37922-3355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 04/06/2020 |