Plunkett, Mallory A
Plunkett, Mallory A is an sole proprietor health care provider with primary practice located at 2900 W Oklahoma Ave , Milwaukee WI 53215-4330. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as her primary health care specialty. Plunkett, Mallory A can be contacted via phone (414) 649-6000.Contact Information
Primary practice address
2900 W Oklahoma Ave
Milwaukee WI 53215-4330
Phone: (414) 649-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant | 367H00000X | 162-017 | Wisconsin |
Profile Details
| NPI number | 1972122448 |
|---|---|
| LBN Legal business name | Plunkett, Mallory A |
| Credentials | Associate of Arts (AA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 14th, 2020 |
| Last updated | Jun 26th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972122448 | NPPES |
| Wisconsin | MEDICAID | 100100845 |
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