Healthcare Provider Details

I. General information

NPI: 1437963972
Provider Name (Legal Business Name): ALEXANDRIA NICHOLE SUMMERS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA NICHOLE SUMMERS

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MAIN ST N
SECTION AL
35771-7168
US

IV. Provider business mailing address

309 TAYLOR ST
SCOTTSBORO AL
35768-2421
US

V. Phone/Fax

Practice location:
  • Phone: 256-228-3471
  • Fax: 256-228-7289
Mailing address:
  • Phone: 256-259-5313
  • Fax: 256-259-4923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-165982
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: