Provider Demographics
NPI:1336804954
Name:PLUMMER, DEBRA PRITCHETT (CNA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:PRITCHETT
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-2423
Mailing Address - Country:US
Mailing Address - Phone:409-239-5652
Mailing Address - Fax:409-239-5455
Practice Address - Street 1:4465 WOODCREST DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-2423
Practice Address - Country:US
Practice Address - Phone:409-239-5652
Practice Address - Fax:409-239-5455
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10349739374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide