Provider Demographics
NPI:1881445096
Name:SUMMERFIELD, TROY JOSEPH (CRNA)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:JOSEPH
Last Name:SUMMERFIELD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 PINOAK PL
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8037
Mailing Address - Country:US
Mailing Address - Phone:870-205-1305
Mailing Address - Fax:
Practice Address - Street 1:1606 PINOAK PL
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-8037
Practice Address - Country:US
Practice Address - Phone:870-205-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR087467390200000X
NM79991367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program