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General NPI Number Information
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NPI Number | 1356665020
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Entity Type | Organization
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Legal Business Name | SUMMER SUN
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 118 HWY 70 E
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City | DICKSON
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State | TN
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Zip | 37055-7039
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Country | US
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Telephone | 615-446-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 118 HWY 70 E
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City | DICKSON
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State | TN
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Zip | 37055-7039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. SUMMER KEASLER
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Credential | APN
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Telephone | 615-995-0767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12244
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License Number State | TN
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