1417210634 NPI number — TOLA LOUISE PLUSNICK RN, APRN, CPNP-PC

Table of content: TOLA LOUISE PLUSNICK RN, APRN, CPNP-PC (NPI 1417210634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417210634 NPI number — TOLA LOUISE PLUSNICK RN, APRN, CPNP-PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLUSNICK
Provider First Name:
TOLA
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, APRN, CPNP-PC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417210634
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
698 HIGH POINT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEATHERFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76088-8379
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-202-9409
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 W HUBBARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINERAL WELLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76067-4846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-468-2000
Provider Business Practice Location Address Fax Number:
800-578-0618
Provider Enumeration Date:
06/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  AP112711 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com