Healthcare Provider Details

I. General information

NPI: 1356819494
Provider Name (Legal Business Name): KATHY D SUMMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 FRANKLIN ST NE APT 110
WASHINGTON DC
20018-4204
US

IV. Provider business mailing address

321 LINCOLN AVE
ROCKVILLE MD
20850-1229
US

V. Phone/Fax

Practice location:
  • Phone: 202-276-1415
  • Fax:
Mailing address:
  • Phone: 240-401-5949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: