Provider Demographics
NPI:1760798516
Name:EYBERG, SUMMER DAWN
Entity Type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:DAWN
Last Name:EYBERG
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 1:11275 PINEDALE DR
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-7910
Mailing Address - Country:US
Mailing Address - Phone:573-202-5386
Mailing Address - Fax:
Practice Address - Street 1:11275 PINEDALE DR
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-7910
Practice Address - Country:US
Practice Address - Phone:573-202-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula