Provider Demographics
NPI:1265810287
Name:PLUMMER, REGINA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:MARIE
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:MARIE
Other - Last Name:KOLKOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:402-354-3370
Mailing Address - Fax:
Practice Address - Street 1:8303 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4108
Practice Address - Country:US
Practice Address - Phone:402-354-4540
Practice Address - Fax:402-354-4535
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2360207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty