Provider Demographics
NPI:1497192090
Name:SUMMERS, PAMELA (RN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6213
Mailing Address - Country:US
Mailing Address - Phone:803-739-3791
Mailing Address - Fax:803-739-3198
Practice Address - Street 1:1520 DUKE ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-6213
Practice Address - Country:US
Practice Address - Phone:803-739-3791
Practice Address - Fax:803-739-3198
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN.17863163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool