Healthcare Provider Details

I. General information

NPI: 1518893841
Provider Name (Legal Business Name): RACHEL LEE SUMMO
Entity Type: Individual
Gender: Female
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

6201 N SANTA FE AVE STE 1010
OKLAHOMA CITY OK
73118-7532
US

IV. Provider business mailing address

7308 SUNSET SAIL AVE
EDMOND OK
73034-8789
US

V. Phone/Fax

Practice location:
  • Phone: 405-772-8687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14-154314-101
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: