Provider Demographics
NPI:1184394454
Name:PLUMLEY, TIFFANY LYNN
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNN
Last Name:PLUMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 PALESTINE RD
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:WV
Mailing Address - Zip Code:25503-9535
Mailing Address - Country:US
Mailing Address - Phone:304-576-2122
Mailing Address - Fax:
Practice Address - Street 1:2275 PALESTINE RD
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:WV
Practice Address - Zip Code:25503-9535
Practice Address - Country:US
Practice Address - Phone:304-576-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant