Individual provider Active NPI

Kama Dawn Plucker, REGISTERED NURSE

  • Registered Nurse
  • Richland, WA
National Provider Identifier
1447895362
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00123736 Issued in WA
Practice address
1480 Fowler St
Richland, WA 99352-4717
Phone
(509) 783-7416
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00123736 WA Primary

Addresses

Primary practice location

1480 Fowler St
Richland, WA 99352-4717

Mailing address

726 Crestview PL
Walla Walla, WA 99362-4230
Phone (509) 301-1589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN00123736WAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1447895362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 CRESTVIEW PL",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624230",
            "telephone_number": "509-301-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 FOWLER ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524717",
            "telephone_number": "509-783-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUCKER",
        "first_name": "KAMA",
        "middle_name": "DAWN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00123736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.