Provider Demographics
NPI:1376550756
Name:SUMMERS, SUSAN BRIDGET (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:BRIDGET
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US DEPARTMENT OF STATE M/MED/QI
Mailing Address - Street 2:2401 E STREET NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20522-0001
Mailing Address - Country:US
Mailing Address - Phone:202-663-2453
Mailing Address - Fax:202-663-3247
Practice Address - Street 1:US DEPARTMENT OF STATE M/MED/QI
Practice Address - Street 2:2401 E STREET NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0001
Practice Address - Country:US
Practice Address - Phone:202-663-2453
Practice Address - Fax:202-663-3247
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR42143363LF0000X
WAAP30000241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily