Provider Demographics
NPI:1972331023
Name:PLASABAS, LADY ANNE MARGOTTE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LADY
Middle Name:ANNE MARGOTTE
Last Name:PLASABAS
Suffix:
Gender:F
Credentials:AGACNP-BC
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Other - Credentials:
Mailing Address - Street 1:8558 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7032
Mailing Address - Country:US
Mailing Address - Phone:219-392-7084
Mailing Address - Fax:219-703-6854
Practice Address - Street 1:100 W CHICAGO AVE STE F
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3261
Practice Address - Country:US
Practice Address - Phone:219-392-7016
Practice Address - Fax:219-947-6904
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71015607A363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology