Provider Demographics
NPI:1407117369
Name:PLUMMER-BRUNETTO, JULIEANNA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:JULIEANNA
Middle Name:MARIE
Last Name:PLUMMER-BRUNETTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 MAIN ST
Mailing Address - Street 2:OFFICE 310
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-7128
Mailing Address - Country:US
Mailing Address - Phone:802-246-1304
Mailing Address - Fax:802-246-1314
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:OFFICE 310
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7128
Practice Address - Country:US
Practice Address - Phone:802-246-1304
Practice Address - Fax:802-246-1314
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0028740163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT026.0028740OtherBOARD OF NURSING CERTIFICATION