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Individual
SUMMER WATT
Active
Individual
SUMMER WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28141704A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008502A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71008502A
INDIANA APN LICENSE
IN
01
—
71008502B
IN CSR LICENSE
IN
Enumeration date
09/06/2018
Last updated
06/17/2019
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