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General NPI Number Information
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NPI Number | 1407588486
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Entity Type | Individual
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Provider Name | MIRANDA DAWN PLUMLEY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 275 DRY HILL RD
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City | BECKLEY
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State | WV
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Zip | 25801-2605
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Country | US
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Telephone | 304-253-6060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | CRAB ORCHARD
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State | WV
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Zip | 25827-1325
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Country | US
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Telephone | 304-237-1784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 113674
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License Number State | WV
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