Provider Demographics
NPI:1679000996
Name:AYERS, SOMMER (FNP)
Entity Type:Individual
Prefix:
First Name:SOMMER
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FOUR MILE DR STE 16
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2665
Mailing Address - Country:US
Mailing Address - Phone:406-314-4095
Mailing Address - Fax:
Practice Address - Street 1:80 FOUR MILE DR STE 16
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2665
Practice Address - Country:US
Practice Address - Phone:406-314-4095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22730363LF0000X
MT161482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily