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General NPI Number Information
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NPI Number | 1730949116
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Entity Type | Individual
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Provider Name | SHATERRA S PLUMMER FNP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 4101 BALTIMORE NATIONAL PIKE
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City | MOUNT AIRY
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State | MD
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Zip | 21771-4115
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Country | US
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Telephone | 301-829-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 3004 HOWARD PARK AVE
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City | GWYNN OAK
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State | MD
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Zip | 21207-6714
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Country | US
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Telephone | 443-803-0774
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R212781
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License Number State | MD
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