Provider Demographics
NPI:1699351213
Name:KUMMER, NANCY JEAN (LMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:KUMMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CAROTHERS ST
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-2608
Mailing Address - Country:US
Mailing Address - Phone:214-282-9294
Mailing Address - Fax:
Practice Address - Street 1:638 US-190 W
Practice Address - Street 2:TOWN SQUARE SHOPPING CENTER
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522
Practice Address - Country:US
Practice Address - Phone:214-282-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118588225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist