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General NPI Number Information
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NPI Number | 1386284123
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Entity Type | Individual
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Provider Name | JENNIFER R SUMMERS APRN
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 37 BALL PARK RD
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City | HARLAN
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State | KY
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Zip | 40831-1701
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Country | US
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Telephone | 606-573-4520
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Fax |
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Provider Business Mailing Address
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Address Line | 195 DREW WOODS
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City | LOYALL
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State | KY
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Zip | 40854
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Country | US
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Telephone | 606-273-2826
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3014173
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License Number State | KY
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