Provider Demographics
NPI:1841203155
Name:PLOTT, ELIZABETH NELSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:NELSON
Last Name:PLOTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W QUEENSBURY LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-6627
Mailing Address - Country:US
Mailing Address - Phone:256-766-0504
Mailing Address - Fax:256-764-6092
Practice Address - Street 1:1161 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:KILLEN
Practice Address - State:AL
Practice Address - Zip Code:35645
Practice Address - Country:US
Practice Address - Phone:256-757-1161
Practice Address - Fax:256-757-1132
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9164183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL#9164OtherPHARMACY LICENSE