Healthcare Provider Details

I. General information

NPI: 1306709159
Provider Name (Legal Business Name): AARON SUMMERSKILL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 N MACOMB ST
MONROE MI
48162-7815
US

IV. Provider business mailing address

718 N MACOMB ST
MONROE MI
48162-7815
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-7722
  • Fax: 419-479-2696
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704420883
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: