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General NPI Number Information
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NPI Number | 1336192376
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Entity Type | Individual
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Provider Name | DOROTHY LEE SUMMERLIN- GRADY CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 8051 S EMERSON AVE STE 150
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8635
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Country | US
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Telephone | 317-865-2955
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Fax | 317-865-2954
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Provider Business Mailing Address
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Address Line | 5955 CLAYBOURNE DR
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City | BARGERSVILLE
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State | IN
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Zip | 46106-8391
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Country | US
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Telephone | 317-966-5576
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 303499
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28151003C
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3420422
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License Number State | FL
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