Provider Demographics
NPI:1982890273
Name:SUMMERS, KAREN S (CNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:S
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7767 W IRLO BRONSON HWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1727
Mailing Address - Country:US
Mailing Address - Phone:321-677-3165
Mailing Address - Fax:
Practice Address - Street 1:6674 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2048
Practice Address - Country:US
Practice Address - Phone:614-834-8000
Practice Address - Fax:614-834-8917
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-254750163W00000X
OHNP-09613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2879603Medicaid