Provider Demographics
NPI:1619271160
Name:PLOCH, SHELLEY WEBB (APN)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:WEBB
Last Name:PLOCH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 STEAM PLANT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3032
Mailing Address - Country:US
Mailing Address - Phone:615-451-4581
Mailing Address - Fax:615-451-5486
Practice Address - Street 1:300 STEAM PLANT RD
Practice Address - Street 2:SUITE 230
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3032
Practice Address - Country:US
Practice Address - Phone:615-451-5481
Practice Address - Fax:615-451-5486
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN15464363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care