Provider Demographics
NPI:1700294733
Name:SUMNER, ANGELA KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHERINE
Last Name:SUMNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-3117
Mailing Address - Country:US
Mailing Address - Phone:501-676-2247
Mailing Address - Fax:501-676-3833
Practice Address - Street 1:115 W FRONT ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-3117
Practice Address - Country:US
Practice Address - Phone:501-676-2247
Practice Address - Fax:501-676-3833
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD085031835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist