Provider Demographics
NPI:1285702803
Name:PLUMMER, JOAN LYNETTE (RD LMNT CDE)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LYNETTE
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:RD LMNT CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32396 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8727
Mailing Address - Country:US
Mailing Address - Phone:402-562-4462
Mailing Address - Fax:402-562-3326
Practice Address - Street 1:4600 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1664
Practice Address - Country:US
Practice Address - Phone:402-562-4462
Practice Address - Fax:402-562-3326
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE638133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE81052OtherCCH BCBS MNT PROV
NE81052OtherCCH BCBS MNT PROV