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General NPI Number Information
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NPI Number | 1497029003
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Entity Type | Individual
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Provider Name | SUMMER GILBERT BASS CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 2455 BELL RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-4336
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Country | US
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Telephone | 334-747-8970
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Fax | 334-747-8980
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Provider Business Mailing Address
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Address Line | 301 BROWN SPRINGS RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-7005
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Country | US
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Telephone | 334-747-4159
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-101954
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License Number State | AL
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