Provider Demographics
NPI:1942236757
Name:WOLFE, SUMMER (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 E SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-5827
Mailing Address - Country:US
Mailing Address - Phone:928-774-4523
Mailing Address - Fax:
Practice Address - Street 1:951 E SAWMILL RD
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5827
Practice Address - Country:US
Practice Address - Phone:928-774-4523
Practice Address - Fax:928-226-5228
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-08-30
Deactivation Date:2012-03-22
Deactivation Code:
Reactivation Date:2020-03-11
Provider Licenses
StateLicense IDTaxonomies
AZLAC-11825101Y00000X
AZ236722363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor