MEDICARE: MS. JOANN CAROLYN SUMNER FNP

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	363LF0000X	Family Nurse Practitioner	056393	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81299	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174732978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANN CAROLYN SUMNER FNP

Provider Business Mailing Address
First Line	:	PO BOX 2034
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-2034
Country	:	US
Telephone Number	:	828-586-8160
Fax Number	:	828-586-8209

Provider Business Practice Location Address
First Line	:	10130 PERIMETER PKWY
Second Line	:	STE 200
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-2447
Country	:	US
Telephone Number	:	888-849-7379
Fax Number	:	855-857-7333

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	01/03/2014

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