Provider Demographics
NPI:1134365380
Name:PLUMMER, KATHERINE J (CNM)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 COVENTRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-2206
Mailing Address - Country:US
Mailing Address - Phone:802-334-5822
Mailing Address - Fax:802-334-5812
Practice Address - Street 1:79 COVENTRY ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-2206
Practice Address - Country:US
Practice Address - Phone:802-334-5822
Practice Address - Fax:802-334-5812
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0028183367A00000X
TX1056142367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife