Individual
MS. JACQUELINE D PLUMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
300 E HOSPITAL ROAD, DDEAMC, FAMILY PRACTICE CLINIC, 2ND FLOOR, FORT GORDON, GA 30905-5650
(706) 787-2927
(706) 787-9356
Mailing address
300 EAST HOSPITAL ROAD, DDEAMC FAMILY PRACTICE CLINIC, 2ND FLOOR, FORT GORDON, GA 30905-5650
(706) 787-2927
(706) 787-9356
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
125337
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125337
NURSE LICENSURE
NC
Enumeration date
01/10/2014
Last updated
01/10/2014
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