Provider Demographics
NPI:1568197515
Name:JAMISON, SUMMER DAWN
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:DAWN
Last Name:JAMISON
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 1:8587 OLD TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE BIRCH
Mailing Address - State:WV
Mailing Address - Zip Code:26629-9353
Mailing Address - Country:US
Mailing Address - Phone:304-644-6303
Mailing Address - Fax:
Practice Address - Street 1:8587 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:LITTLE BIRCH
Practice Address - State:WV
Practice Address - Zip Code:26629-9353
Practice Address - Country:US
Practice Address - Phone:304-644-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant