Provider Demographics
NPI:1487026928
Name:SUMMER, CAROLYN (AGNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SUMMER
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251B SARATOGA AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1025
Mailing Address - Country:US
Mailing Address - Phone:202-832-8818
Mailing Address - Fax:202-548-8600
Practice Address - Street 1:1251B SARATOGA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1025
Practice Address - Country:US
Practice Address - Phone:202-832-8818
Practice Address - Fax:202-548-8600
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1039110163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse