Individual
NICKY PLEMENTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 219-2000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
44280-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34186800
—
WI
Enumeration date
08/05/2006
Last updated
12/01/2021
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