Healthcare Provider Details

I. General information

NPI: 1992385900
Provider Name (Legal Business Name): MRS. SUMMER VRONA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS SUMMER SIMS

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4914 YOUNGSTOWN POLAND RD
YOUNGSTOWN OH
44514-1152
US

IV. Provider business mailing address

7057 LUTERAN LN
YOUNGSTOWN OH
44514-2242
US

V. Phone/Fax

Practice location:
  • Phone: 330-755-2421
  • Fax:
Mailing address:
  • Phone: 702-327-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberOH346629
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: