Healthcare Provider Details

I. General information

NPI: 1295068765
Provider Name (Legal Business Name): SUSAN JILL SOMMERS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL SOMMERS CNP

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 S ARLINGTON RD
AKRON OH
44312-4716
US

IV. Provider business mailing address

2818 S ARLINGTON RD
AKRON OH
44312-4716
US

V. Phone/Fax

Practice location:
  • Phone: 330-645-0148
  • Fax: 330-645-1524
Mailing address:
  • Phone: 330-645-0148
  • Fax: 330-645-1524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA10781NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: