Basic Information
| Provider Information | |||||||||
| NPI: | 1487026928 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUMMER | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | |||||||||
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| Credential: | AGNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1251B SARATOGA AVE NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200181025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328818 | ||||||||
| FaxNumber: | 2025488600 | ||||||||
| Practice Location | |||||||||
| Address1: | 1251B SARATOGA AVE NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200181025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328818 | ||||||||
| FaxNumber: | 2025488600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2015 | ||||||||
| LastUpdateDate: | 04/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN1039110 | DC | N | Nursing Service Providers | Registered Nurse | 363LA2200X | RN1039110 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.