Healthcare Provider Details

I. General information

NPI: 1912834672
Provider Name (Legal Business Name): KATIE PLUKAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

19366 E REINS RD
QUEEN CREEK AZ
85142-8626
US

V. Phone/Fax

Practice location:
  • Phone: 623-343-3928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: KATIE PLUKAS
Title or Position: OWNER
Credential:
Phone: 623-343-3928