Healthcare Provider Details

I. General information

NPI: 1508652389
Provider Name (Legal Business Name): PATRICIA SUSAN PLOTKOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 15 MILE RD
STERLING HEIGHTS MI
48312-4511
US

IV. Provider business mailing address

6555 15 MILE RD
STERLING HEIGHTS MI
48312-4511
US

V. Phone/Fax

Practice location:
  • Phone: 586-469-7792
  • Fax:
Mailing address:
  • Phone: 586-469-7792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704273370
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: