Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 9322 | WI |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 9322 | WI |
NPI | 1033574744 |
---|---|
Provider Name | Tiffany Pluger |
First Address | Wausau, WI 54403-6785 |
Second Address | Wausau, WI 54403-6785 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2015 |
Last Update Date | 31/03/2021 |