Healthcare Provider Details

I. General information

NPI: 1710769773
Provider Name (Legal Business Name): CHASITY PLOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4977 NORTHCUTT PL
DAYTON OH
45414-3839
US

IV. Provider business mailing address

4977 NORTHCUTT PL
DAYTON OH
45414-3839
US

V. Phone/Fax

Practice location:
  • Phone: 800-829-5461
  • Fax: 937-813-4114
Mailing address:
  • Phone:
  • Fax: 937-813-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN524000
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: