Provider Demographics
NPI:1689613168
Name:SUMMERS, PATRICIA B (CNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:B
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 SOUTH VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-745-4812
Mailing Address - Fax:330-745-5464
Practice Address - Street 1:1423 SOUTH VAN BUREN AVE.
Practice Address - Street 2:B&W WELLNESS CENTER
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2432
Practice Address - Country:US
Practice Address - Phone:330-745-4812
Practice Address - Fax:330-745-5464
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP01076363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2265249Medicaid
OH2265269Medicaid
OH2265249Medicaid
SUNP20113Medicare PIN