Provider Demographics
NPI:1245860923
Name:PLUNKETT, ANGELA (RN, BSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:PLUNKETT
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 LONE JACK LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3850
Mailing Address - Country:US
Mailing Address - Phone:901-568-9202
Mailing Address - Fax:
Practice Address - Street 1:1709 LONE JACK LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3850
Practice Address - Country:US
Practice Address - Phone:901-568-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN176112163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant