Doctor Name: | TOLA LOUISE PLUSNICK |
NPI Number: | 1417210634 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, CPNP |
License Number: | 626220 |
Business Practice Address: | 102 Holly Hill Rd Mineral Wells, TX - 760675042 |
Business Phone Number: | 9403250378 |
Business Fax Number: | |
Mailing Address: | 102 Holly Hill Rd, MINERAL WELLS |
State: | TX |
Postal Code: | 760675042 |
Phone Number: | 9403250378 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 626220 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |