Provider Demographics
NPI:1437024460
Name:PORTER, SUMMER EFFIEMAE
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:EFFIEMAE
Last Name:PORTER
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 1:18 TWIN PINE TRAIL
Mailing Address - Street 2:
Mailing Address - City:KISTLER
Mailing Address - State:WV
Mailing Address - Zip Code:25628
Mailing Address - Country:US
Mailing Address - Phone:681-472-7438
Mailing Address - Fax:
Practice Address - Street 1:18 TWIN PINE TRAIL
Practice Address - Street 2:
Practice Address - City:KISTLER
Practice Address - State:WV
Practice Address - Zip Code:25628
Practice Address - Country:US
Practice Address - Phone:681-472-7438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant