Provider Demographics
NPI:1275358905
Name:PLUMMER, MOLLY (LVN, IBCLC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:LVN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CATHERINE CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8622
Mailing Address - Country:US
Mailing Address - Phone:530-521-3509
Mailing Address - Fax:
Practice Address - Street 1:701 CATHERINE CT
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8622
Practice Address - Country:US
Practice Address - Phone:530-521-3509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236766164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse