Healthcare Provider Details

I. General information

NPI: 1699601997
Provider Name (Legal Business Name): SEAN SUMMMERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 N 107TH PLZ
OMAHA NE
68122-3044
US

IV. Provider business mailing address

1910 S 44TH ST STE 202
OMAHA NE
68105-2849
US

V. Phone/Fax

Practice location:
  • Phone: 402-214-6380
  • Fax:
Mailing address:
  • Phone: 402-214-6380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: