=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881505147
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BREANN MAE PLUMMER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2026
-----------------------------------------------------
Last Update Date | 09/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1765 HARBOR DR
-----------------------------------------------------
City | CHESTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21619-2168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-233-0787
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1765 HARBOR DR
-----------------------------------------------------
City | CHESTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21619-2168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 53-82704-012
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------