Healthcare Provider Details

I. General information

NPI: 1922747724
Provider Name (Legal Business Name): SUMMER CRISANDRA EATON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N DOBSON RD
SCOTTSDALE AZ
85256-2736
US

IV. Provider business mailing address

7016 W QUAIL AVE
GLENDALE AZ
85308-9431
US

V. Phone/Fax

Practice location:
  • Phone: 480-733-7400
  • Fax:
Mailing address:
  • Phone: 623-680-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNA
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: