Plock, Lisa M

Plock, Lisa M is an individual health care provider with primary practice located at 2000 10Th Ave Suite 200, Columbus GA 31901-3700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Plock, Lisa M can be contacted via phone (706) 321-3745.

Contact Information

Primary practice address
2000 10Th Ave Suite 200 Columbus GA 31901-3700
Fax: (706) 321-3749
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN075180 Georgia

Profile Details

NPI number 1528056660
LBN Legal business name Plock, Lisa M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 7th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528056660 NPPES
Georgia MEDICAID 000806649E
Georgia Other 581719867066

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