Individual ProviderAngela Louise PlemmonsNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3998 Fair Ridge Dr, Suite 300, Fairfax, VA 22033-2921(703) 766-9737(703) 295-9360PECOS EnrollmentBased on the most recent information from CMS, provider Angela Louise Plemmons does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1265839062Provider TypeIndividualFull NamePlemmons, Angela LouiseCredentialRNGenderFemaleSole ProprietorYesEnumeration Date11/24/2014Last Updated2/17/2015Contact InformationPractice LocationPractice Address3998 Fair Ridge Dr, Suite 300, Fairfax, VA 22033-2921Phone(703) 766-9737Fax(703) 766-9725Mailing LocationMailing AddressPO Box 37090, Baltimore, MD 21297-3090Phone(703) 295-9360FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024172313VirginiaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicenseRN156865ArizonaProvider IdentifiersIDDescriptionIssuerID1265839062DescriptionMedicaidIssuerUnlistedVirginia