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Individual

JACQUOLYNN LEE PLOUGHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN, RN, CRRN

Contact information

Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4699
(260) 266-4172
Mailing address
1282 SACRED OAK CT, FORT WAYNE, IN 46818-0142
(260) 530-6126

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28198300A
IN

Other

Enumeration date
04/10/2023
Last updated
04/10/2023
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