Provider Demographics
NPI:1609564830
Name:PLUMERY, ANA (RN)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:PLUMERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANA SYLVIA
Other - Middle Name:
Other - Last Name:GOETTEN DE SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2031 ROSE FAMILY DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4188
Mailing Address - Country:US
Mailing Address - Phone:314-363-5390
Mailing Address - Fax:
Practice Address - Street 1:2031 ROSE FAMILY DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4188
Practice Address - Country:US
Practice Address - Phone:314-363-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001295604163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse