Provider Demographics
NPI:1578585998
Name:PLUMER, PATRICIA ANN (MSN, RN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:PLUMER
Suffix:
Gender:F
Credentials:MSN, RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 DOSIER CV W
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3283
Mailing Address - Country:US
Mailing Address - Phone:817-236-3022
Mailing Address - Fax:
Practice Address - Street 1:8001 WESTERN HILLS BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-3524
Practice Address - Country:US
Practice Address - Phone:817-236-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX598091363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11988404Medicaid
TX8C9716Medicare ID - Type UnspecifiedMEDICARE
TX82N295Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL GROUP
TXS38529Medicare UPIN
TX11988404Medicaid