Provider Demographics
NPI:1497029003
Name:BASS, SUMMER GILBERT (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:GILBERT
Last Name:BASS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2455 BELL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4336
Practice Address - Country:US
Practice Address - Phone:334-747-8970
Practice Address - Fax:334-747-8980
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101954363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALA01473AOtherMEDICARE
ALZ54548OtherVIVA HEALTH
AL217644Medicaid
AL512-10643OtherBCBS OF ALABAMA
ALP02068129OtherRAILROAD MEDICARE
AL512-10745OtherBCBS OF ALABAMA
AL217507Medicaid