Provider Demographics
NPI:1457956625
Name:PATTON, SUMMER N (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:N
Last Name:PATTON
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72392-0128
Mailing Address - Country:US
Mailing Address - Phone:870-589-3675
Mailing Address - Fax:
Practice Address - Street 1:245 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:AR
Practice Address - Zip Code:72029-2706
Practice Address - Country:US
Practice Address - Phone:870-747-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1868133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered