MEDICARE: SUMMER DAWN HUNCOVSKY APRN

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	363L00000X	Nurse Practitioner	77805	KS
2	163W00000X	Registered Nurse	98848	KS

General Provider Information

NPI Number	:	1194255125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMMER DAWN HUNCOVSKY APRN

Provider Business Mailing Address
First Line	:	8779 N KELLIANN WAY
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-1595
Country	:	US
Telephone Number	:	785-259-0165
Fax Number	:

Provider Business Practice Location Address
First Line	:	8779 N KELLIANN WAY
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-1595
Country	:	US
Telephone Number	:	785-259-0165
Fax Number	:

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

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	04/06/2026

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Directions to “ SUMMER DAWN HUNCOVSKY APRN” Practice Location

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