Provider Demographics
NPI:1487838579
Name:PLUMLEY, BETTE ANN (OTR)
Entity type:Individual
Prefix:MS
First Name:BETTE
Middle Name:ANN
Last Name:PLUMLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 WINSOR PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8929
Mailing Address - Country:US
Mailing Address - Phone:219-663-0869
Mailing Address - Fax:
Practice Address - Street 1:8380 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6231
Practice Address - Country:US
Practice Address - Phone:219-769-9069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-25
Last Update Date:2007-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000201A171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor