Healthcare Provider Details

I. General information

NPI: 1730949116
Provider Name (Legal Business Name): SHATERRA S PLUMMER DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 HOWARD PARK AVE
GWYNN OAK MD
21207-6714
US

IV. Provider business mailing address

3004 HOWARD PARK AVE
GWYNN OAK MD
21207-6714
US

V. Phone/Fax

Practice location:
  • Phone: 443-803-0774
  • Fax:
Mailing address:
  • Phone: 443-803-0774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR212781
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: