Healthcare Provider Details

I. General information

NPI: 1902082977
Provider Name (Legal Business Name): MONICA MARIE PLOOF MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2008
Last Update Date: 01/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE SMITH 568
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVE SMITH 568
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-2850
  • Fax: 802-847-5557
Mailing address:
  • Phone: 802-847-2850
  • Fax: 802-847-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number101-0019272
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: