Healthcare Provider Details

I. General information

NPI: 1689204216
Provider Name (Legal Business Name): SUMMER BROOKE DUTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 W BROADWAY ST
ANADARKO OK
73005-2426
US

IV. Provider business mailing address

605 W BROADWAY ST
ANADARKO OK
73005-2426
US

V. Phone/Fax

Practice location:
  • Phone: 405-933-1999
  • Fax:
Mailing address:
  • Phone: 405-933-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: