Basic Information
| Provider Information | |||||||||
| NPI: | 1427287259 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLONSKA | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5450 WESTERN AVE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BOULDER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 803012709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034157599 | ||||||||
| FaxNumber: | 3035305474 | ||||||||
| Practice Location | |||||||||
| Address1: | 6685 GUNPARK DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | BOULDER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 803013343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035303062 | ||||||||
| FaxNumber: | 3035305474 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2009 | ||||||||
| LastUpdateDate: | 11/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DR-51485 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.