Provider Demographics
NPI:1851810055
Name:SUMMERS, DANIELL M (NP)
Entity Type:Individual
Prefix:
First Name:DANIELL
Middle Name:M
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12546 E US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:LOOGOOTEE
Mailing Address - State:IN
Mailing Address - Zip Code:47553-5220
Mailing Address - Country:US
Mailing Address - Phone:812-295-5095
Mailing Address - Fax:812-295-9403
Practice Address - Street 1:202 N WEST ST
Practice Address - Street 2:
Practice Address - City:ODON
Practice Address - State:IN
Practice Address - Zip Code:47562-1032
Practice Address - Country:US
Practice Address - Phone:812-636-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28196995A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily