Provider Demographics
NPI:1689969347
Name:PLUMLEE, SHERRI RAE (RN)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:RAE
Last Name:PLUMLEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 E FREEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72616-3533
Mailing Address - Country:US
Mailing Address - Phone:870-423-2244
Mailing Address - Fax:
Practice Address - Street 1:719 FRONT ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5421
Practice Address - Country:US
Practice Address - Phone:501-900-4549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR50615156F00000X
ARR050615163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No156F00000XEye and Vision Services ProvidersTechnician/Technologist