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NPI Code Detail

MEDICARE: MRS. SUMMER R. CROSS A.P.R.N.

MEDICARE: MRS. SUMMER R. CROSS A.P.R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3005504KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000610458OTHERKYBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275711491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUMMER R. CROSS A.P.R.N.
Provider Business Mailing Address
First Line : PO BOX 497
Second Line :
City : AUGUSTA
State : AR
Zip : 72006-0497
Country : US
Telephone Number : 870-347-2534
Fax Number : 870-301-2092
Provider Business Practice Location Address
First Line : 312 S 8TH ST
Second Line :
City : MURRAY
State : KY
Zip : 42071-2428
Country : US
Telephone Number : 270-753-2395
Fax Number : 270-759-4745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2008
Last Update Date : 09/15/2022

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