Provider Demographics
NPI:1780066761
Name:SUMMERS, CAROL (CRNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 RITCHIE HWY STE B
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2244
Mailing Address - Country:US
Mailing Address - Phone:410-793-5212
Mailing Address - Fax:
Practice Address - Street 1:1300 RITCHIE HWY STE B
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2244
Practice Address - Country:US
Practice Address - Phone:410-793-5212
Practice Address - Fax:410-793-5212
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR116883363LN0005X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care