Healthcare Provider Details

I. General information

NPI: 1144026915
Provider Name (Legal Business Name): ELIZABETH KATHERINE PLUEMER BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 DEERFIELD DR W
NORTH LIBERTY IA
52317-4705
US

IV. Provider business mailing address

1575 DEERFIELD DR W
NORTH LIBERTY IA
52317-4705
US

V. Phone/Fax

Practice location:
  • Phone: 319-540-5595
  • Fax:
Mailing address:
  • Phone: 319-540-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: