Provider Demographics
NPI:1437546041
Name:SUMMERS, STEELE (FNP)
Entity Type:Individual
Prefix:
First Name:STEELE
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:STEELE
Other - Middle Name:ELLEN
Other - Last Name:HICKMNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2663
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:9002 N MERIDIAN ST STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5349
Practice Address - Country:US
Practice Address - Phone:317-848-5349
Practice Address - Fax:317-924-8239
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28177415A363L00000X
IN71005694A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1127011OtherMEDICARE PTAN
IN201324240Medicaid
ININ1125012OtherMEDICARE PTAN
ININ1127010OtherMEDICARE PTAN