Provider Demographics
NPI:1821572983
Name:PLAGGE, KATIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:PLAGGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HASSEBROEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4304 NEW YORK AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-3437
Mailing Address - Country:US
Mailing Address - Phone:605-261-4617
Mailing Address - Fax:
Practice Address - Street 1:105 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3323
Practice Address - Country:US
Practice Address - Phone:515-232-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22701835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22270OtherIOWA BOARD OF PHARMACY