Healthcare Provider Details

I. General information

NPI: 1992570444
Provider Name (Legal Business Name): AMY EILEEN PLOTT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18452 BUSINESS 13
BRANSON WEST MO
65737-9609
US

IV. Provider business mailing address

18452 BUSINESS 13
BRANSON WEST MO
65737-9609
US

V. Phone/Fax

Practice location:
  • Phone: 417-272-8911
  • Fax:
Mailing address:
  • Phone: 417-272-8911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number2000160153
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023046004
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: