Provider Demographics
NPI:1689890337
Name:PHELPS, SUMMER MARIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:MARIE
Last Name:PHELPS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:SUMMER
Other - Middle Name:MARIE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:AL
Mailing Address - Zip Code:36250-0285
Mailing Address - Country:US
Mailing Address - Phone:256-831-8100
Mailing Address - Fax:256-831-8128
Practice Address - Street 1:388 TERRACE MEADOW DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:AL
Practice Address - Zip Code:36279-4101
Practice Address - Country:US
Practice Address - Phone:256-831-8100
Practice Address - Fax:256-831-8128
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily