Provider Demographics
NPI:1679068464
Name:PLUMMER, DANIELLE (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 COULOAK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-7678
Mailing Address - Country:US
Mailing Address - Phone:704-392-9999
Mailing Address - Fax:704-392-9913
Practice Address - Street 1:10220 COULOAK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-7678
Practice Address - Country:US
Practice Address - Phone:704-392-9999
Practice Address - Fax:704-392-9913
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1639350770Medicaid
NC1679068464Medicaid
NC1639350770Medicaid
NC1811485378Medicaid