Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 6928-16 | WI |
NPI | 1023441433 |
---|---|
Provider Name | Nicole Plasky |
First Address | Sheboygan, WI 53082-0959 |
Second Address | Manitowoc, WI 54220-6817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 26/03/2014 |