Provider Demographics
NPI:1215352505
Name:PLAUTZ, EMILY KATE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KATE
Last Name:PLAUTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 PINE LAKE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5415
Mailing Address - Country:US
Mailing Address - Phone:402-483-8700
Mailing Address - Fax:
Practice Address - Street 1:3901 PINE LAKE RD STE 410
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5415
Practice Address - Country:US
Practice Address - Phone:402-483-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant