Provider Demographics
NPI:1508268483
Name:PLASSMEYER, KATRINA J (NP-C)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:J
Last Name:PLASSMEYER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E UNIVERSITY AVE DEPT 3068
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82071-2001
Mailing Address - Country:US
Mailing Address - Phone:307-766-2130
Mailing Address - Fax:307-766-2711
Practice Address - Street 1:1000 E UNIVERSITY AVE DEPT 3068
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82071-2001
Practice Address - Country:US
Practice Address - Phone:307-766-2130
Practice Address - Fax:307-766-2711
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY49729363LF0000X
COAPN.0991335-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49080725Medicaid
CO49080725Medicaid