Healthcare Provider Details

I. General information

NPI: 1518882943
Provider Name (Legal Business Name): ALEXANDRA ANNE SUMMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S HOUSTON AVE STE 400
TULSA OK
74127-9007
US

IV. Provider business mailing address

1439 S NORFOLK AVE
TULSA OK
74120-5610
US

V. Phone/Fax

Practice location:
  • Phone: 918-582-7711
  • Fax:
Mailing address:
  • Phone: 918-810-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231022
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: