Provider Demographics
NPI:1174269070
Name:PLUNTZ, TAYLOR ELIZABETH
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:PLUNTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7519 GIROUD DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-9694
Mailing Address - Country:US
Mailing Address - Phone:317-862-5214
Mailing Address - Fax:
Practice Address - Street 1:11 BOBCAT BLVD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NH
Practice Address - Zip Code:03244-7419
Practice Address - Country:US
Practice Address - Phone:603-478-5236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program