Provider Demographics
NPI:1932574787
Name:LEMMING SUMMERS, COURTNEY A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:A
Last Name:LEMMING SUMMERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:A
Other - Last Name:LEMMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:5151 WINTER GARDEN VINELAND RD STE 208
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6098
Mailing Address - Country:US
Mailing Address - Phone:407-635-3070
Mailing Address - Fax:407-636-7802
Practice Address - Street 1:5151 WINTER GARDEN VINELAND RD STE 208
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6098
Practice Address - Country:US
Practice Address - Phone:407-635-3070
Practice Address - Fax:407-636-7802
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9282573363LF0000X
FLAPRN9282573363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021376200Medicaid