Healthcare Provider Details

I. General information

NPI: 1073717419
Provider Name (Legal Business Name): SHELLEY PLESSINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 CUMBERLAND AVE STE 225
WEST LAFAYETTE IN
47906-1343
US

IV. Provider business mailing address

1305 CUMBERLAND AVE STE 225
WEST LAFAYETTE IN
47906-1343
US

V. Phone/Fax

Practice location:
  • Phone: 866-672-4764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: