Healthcare Provider Details

I. General information

NPI: 1407871775
Provider Name (Legal Business Name): KARA A PLUMMER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA A LAUZE NP

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST
LEWISTON ME
04240-7041
US

IV. Provider business mailing address

PO BOX 62 TURNPIKE STATION
SHREWSBURY MA
01545-0062
US

V. Phone/Fax

Practice location:
  • Phone: 207-795-0111
  • Fax:
Mailing address:
  • Phone: 508-334-8815
  • Fax: 508-334-5374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP121097
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number255393
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: