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General NPI Number Information
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NPI Number | 1104700855
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Entity Type | Individual
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Provider Name | SUMMER ELIZABETH PECK-HAINES
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 4313 S PLEASANT CROSSING BLVD
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City | ROGERS
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State | AR
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Zip | 72758-1347
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Country | US
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Telephone | 479-341-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 136 ARLINGTON DR
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City | SLIPPERY ROCK
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State | PA
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Zip | 16057-1168
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Country | US
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Telephone | 724-992-5669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 234337
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License Number State | AR
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