Healthcare Provider Details

I. General information

NPI: 1629915780
Provider Name (Legal Business Name): SHANA PLAMBECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12247 STRATFORD DR
CLIVE IA
50325-8147
US

IV. Provider business mailing address

3512 WOLF CREEK RD SW
BONDURANT IA
50035-6831
US

V. Phone/Fax

Practice location:
  • Phone: 515-346-3999
  • Fax:
Mailing address:
  • Phone: 515-423-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number159608
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: