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NPI Code Detail

MEDICARE: MRS. BRANDY MONIQUE PLUMMER

MEDICARE: MRS. BRANDY MONIQUE PLUMMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse0002092072VA
2251C00000XDevelopmentally Disabled Services Day Training Agency
3251E00000XHome Health AgencyHCO-232776VA

General Provider Information

NPI Number : 1225596141
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDY MONIQUE PLUMMER
Provider Business Mailing Address
First Line : 13195 WARWICK BLVD STE 2E
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8313
Country : US
Telephone Number : 757-378-4806
Fax Number :
Provider Business Practice Location Address
First Line : 13195 WARWICK BLVD STE 2E
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8313
Country : US
Telephone Number : 757-378-4806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2019
Last Update Date : 11/16/2022

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