Provider Demographics
NPI:1336648815
Name:SUMNER, MARSHA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:LYNN
Last Name:SUMNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 STATE AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4590
Mailing Address - Country:US
Mailing Address - Phone:850-872-3939
Mailing Address - Fax:850-872-3938
Practice Address - Street 1:2202 STATE AVE STE 303
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4590
Practice Address - Country:US
Practice Address - Phone:850-872-3939
Practice Address - Fax:850-872-3938
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily