Provider Demographics
NPI:1295356939
Name:SUMMER, TRACY (FNP-C)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:SUMMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11305 TOMICHI DR
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-8534
Mailing Address - Country:US
Mailing Address - Phone:720-581-2218
Mailing Address - Fax:
Practice Address - Street 1:2400 S RUSSELLVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:CO
Practice Address - Zip Code:80116-8557
Practice Address - Country:US
Practice Address - Phone:303-688-9319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN994156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily