Healthcare Provider Details

I. General information

NPI: 1235643297
Provider Name (Legal Business Name): BETHANY MEE YEONG SUMMERS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9620 E ARAPAHOE RD
GREENWOOD VILLAGE CO
80112-3703
US

IV. Provider business mailing address

9620 E ARAPAHOE RD
GREENWOOD VILLAGE CO
80112-3703
US

V. Phone/Fax

Practice location:
  • Phone: 303-835-9915
  • Fax: 303-320-5399
Mailing address:
  • Phone: 303-835-9915
  • Fax: 303-320-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0993435-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: