Individual
AMANDA RAE PLOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 968-7438
Mailing address
3232 RAUSCH AVE, RAVENNA, OH 44266-1602
(330) 968-7438
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN.433124
OH
164W00000X
Licensed Practical Nurse
PN.152642-M-IV
OH
Other
Enumeration date
04/30/2013
Last updated
05/07/2021
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