Provider Demographics
NPI:1750113718
Name:ROBERSON, SUMMER ANN (NP-C)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:ANN
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8984
Mailing Address - Country:US
Mailing Address - Phone:919-292-2468
Mailing Address - Fax:919-292-2167
Practice Address - Street 1:1303 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-8984
Practice Address - Country:US
Practice Address - Phone:919-292-2468
Practice Address - Fax:919-292-2167
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020662363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty