MEDICARE: NANCY R PLUNK LPC/MHSP

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
1	101YP2500X	Professional Counselor	2682	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992844955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY R PLUNK LPC/MHSP

Provider Business Mailing Address
First Line	:	142 OLD BELLS LOOP
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-9609
Country	:	US
Telephone Number	:	731-697-7185
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 LAMAR CIRCLE
Second Line	:	SUITE 3
City	:	JACKSON
State	:	TN
Zip	:	38305-1528
Country	:	US
Telephone Number	:	731-697-7185
Fax Number	:	731-736-2530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	06/27/2023

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