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General NPI Number Information
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NPI Number | 1962060848
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Entity Type | Individual
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Provider Name | SUMMER SIEVERT PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 01/04/2026
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Provider Practice Location Address
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Address Line | 1043 PEDIGO WAY STE 13
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7197
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Country | US
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Telephone | 270-439-8304
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Fax | 386-217-6025
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Provider Business Mailing Address
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Address Line | 1945 SCOTTSVILLE RD # B2-328
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3376
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Country | US
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Telephone | 386-227-6050
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Fax | 386-217-6025
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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 | 3014591
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11004703
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License Number State | FL
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