Provider Demographics
NPI:1093298002
Name:PUMPHREY, SUMMER ANNA FAYE
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:ANNA FAYE
Last Name:PUMPHREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MC DONALD PIKE
Mailing Address - Street 2:
Mailing Address - City:PAULDING
Mailing Address - State:OH
Mailing Address - Zip Code:45879-9239
Mailing Address - Country:US
Mailing Address - Phone:419-399-3636
Mailing Address - Fax:
Practice Address - Street 1:501 MC DONALD PIKE
Practice Address - Street 2:
Practice Address - City:PAULDING
Practice Address - State:OH
Practice Address - Zip Code:45879-9239
Practice Address - Country:US
Practice Address - Phone:419-399-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator