Healthcare Provider Details

I. General information

NPI: 1528498045
Provider Name (Legal Business Name): SANDRA SUMMERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 6TH AVE SE STE 1
ABERDEEN SD
57401-4950
US

IV. Provider business mailing address

2501 S LOUISE AVE UNIT 90332
SIOUX FALLS SD
57109-4669
US

V. Phone/Fax

Practice location:
  • Phone: 606-250-1200
  • Fax:
Mailing address:
  • Phone: 719-688-9254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0002947-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: