Provider Demographics
NPI:1346859063
Name:PLUMLEE, MIRANDA DAWN (APRN)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:DAWN
Last Name:PLUMLEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:DAWN
Other - Last Name:VANDERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-1832
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:
Practice Address - Street 1:2100 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4951
Practice Address - Country:US
Practice Address - Phone:888-777-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS80330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily