Provider Demographics
NPI:1922747724
Name:EATON, SUMMER CRISANDRA (NP)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:CRISANDRA
Last Name:EATON
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 1:7016 W QUAIL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-9431
Mailing Address - Country:US
Mailing Address - Phone:623-680-1382
Mailing Address - Fax:
Practice Address - Street 1:7400 N DOBSON RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85256-2736
Practice Address - Country:US
Practice Address - Phone:480-733-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNA363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily