Healthcare Provider Details

I. General information

NPI: 1649192261
Provider Name (Legal Business Name): SUMMER ROSE STERLING CNMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BURKARTH RD
WARRENSBURG MO
64093-3101
US

IV. Provider business mailing address

1402 NW RED OAK CT
BLUE SPRINGS MO
64029-8801
US

V. Phone/Fax

Practice location:
  • Phone: 660-747-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number046853
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: