MEDICARE: SUMMER RAYE BORDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	APRN-NP332057	GA

General Provider Information

NPI Number	:	1093672073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMMER RAYE BORDERS

Provider Business Mailing Address
First Line	:	7823 BIG BEN CT
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30236-2776
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 MORELAND AVE SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-1926
Country	:	US
Telephone Number	:	404-688-9300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ SUMMER RAYE BORDERS ” Practice Location

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