Healthcare Provider Details

I. General information

NPI: 1679982292
Provider Name (Legal Business Name): MICHELLE PLAUTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 09/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 CEDAR ST
MERRILL WI
54452-1241
US

IV. Provider business mailing address

1305 CEDAR ST
MERRILL WI
54452-1241
US

V. Phone/Fax

Practice location:
  • Phone: 715-218-0116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number138894
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: