Provider Demographics
NPI:1831829167
Name:MILLER, SUMMER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:
Other - Last Name:DESPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:613 MARQUETTE RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-3038
Mailing Address - Country:US
Mailing Address - Phone:601-331-3658
Mailing Address - Fax:
Practice Address - Street 1:613 MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-3038
Practice Address - Country:US
Practice Address - Phone:601-825-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905369363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health