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General NPI Number Information
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NPI Number | 1750702007
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Entity Type | Individual
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Provider Name | MARY-BETH FENNELL PLUM PHARM.D., BCACP
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Gender | Female
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 7007 HARBOUR VIEW BLVD SUITE 108
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City | SUFFOLK
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State | VA
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Zip | 23435-2719
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Country | US
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Telephone | 757-353-9800
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Fax | 757-215-2729
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Provider Business Mailing Address
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Address Line | 7007 HARBOUR VIEW BLVD SUITE 108
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City | SUFFOLK
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State | VA
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Zip | 23435-2719
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Country | US
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Telephone | 757-353-9800
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Fax | 757-215-2729
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0202012865
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP-043692-L
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License Number State | PA
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