# PLAZA PARK FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336574490
- **Authorized official:** CARLEEN M RUBEL NP (PRESIDENT)
- **Authorized official phone:** (812) 471-4302

## Contact information

- **Practice address:** 3799 VENETIAN WAY, NEWBURGH, IN 47630-8278
- **Practice address phone:** (812) 471-4302
- **Practice address fax:** (812) 471-4303
- **Mailing address:** PO BOX 3276, EVANSVILLE, IN 47731-3276
- **Mailing address phone:** (812) 473-0181
- **Mailing address fax:** (812) 473-5822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01036788A | IN | Yes |
| 363L00000X | Nurse Practitioner | — | IN | — |

## Other

- **Enumeration date:** 09/09/2013
- **Last updated:** 02/27/2024