Provider Demographics
NPI:1275408866
Name:PLOEN, ALYSSA L (RN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:PLOEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28323 BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:SD
Mailing Address - Zip Code:57013-5851
Mailing Address - Country:US
Mailing Address - Phone:605-321-7630
Mailing Address - Fax:
Practice Address - Street 1:28323 BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-5851
Practice Address - Country:US
Practice Address - Phone:605-321-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR060064163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty