Healthcare Provider Details

I. General information

NPI: 1366068447
Provider Name (Legal Business Name): RACHEL BROOKE SUMMERS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. RACHEL BROOKE LANDERS

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 N US HIGHWAY 69
HUNTINGTON TX
75949-8910
US

IV. Provider business mailing address

6194 FM 328
HUNTINGTON TX
75949-3047
US

V. Phone/Fax

Practice location:
  • Phone: 936-876-5719
  • Fax: 936-876-3308
Mailing address:
  • Phone: 936-366-3045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1000192
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: