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General NPI Number Information
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NPI Number | 1487838579
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Entity Type | Individual
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Provider Name | BETTE ANN PLUMLEY OTR
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Gender | Female
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Dates
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Enumeration Date | 12/25/2007
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Last Update Date | 12/25/2007
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Provider Practice Location Address
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Address Line | 8380 VIRGINIA ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6231
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Country | US
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Telephone | 219-769-9069
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Fax |
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Provider Business Mailing Address
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Address Line | 3523 WINSOR PL
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City | CROWN POINT
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State | IN
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Zip | 46307-8929
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Country | US
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Telephone | 219-663-0869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 31000201A
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License Number State | IN
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