Provider Demographics
NPI:1235762543
Name:SUMMER, JULIE ANN E (NP-C)
Entity Type:Individual
Prefix:
First Name:JULIE ANN
Middle Name:E
Last Name:SUMMER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:SCHROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 SINGLETON RIDGE RD
Mailing Address - Street 2:ATTENTION PATIENT ACCOUNTING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6946
Mailing Address - Fax:
Practice Address - Street 1:300 SINGLETON RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9142
Practice Address - Country:US
Practice Address - Phone:843-347-8050
Practice Address - Fax:843-347-8049
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23743363LF0000X
SC218992163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP6920Medicaid