Healthcare Provider Details

I. General information

NPI: 1982847018
Provider Name (Legal Business Name): SUMMER HODGES-LOWERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3643 N ROXBORO ST
DURHAM NC
27704-2702
US

IV. Provider business mailing address

PO BOX 15609
DURHAM NC
27704-0609
US

V. Phone/Fax

Practice location:
  • Phone: 919-470-6185
  • Fax:
Mailing address:
  • Phone: 919-384-0700
  • Fax: 919-384-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number215209
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: