# SUMMERFIELD FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548553803
- **Authorized official:** MS. JULIE A SANDINE RN, MSN, ANP, BC (OWNER)
- **Authorized official phone:** (317) 408-8480

## Contact information

- **Practice address:** 11 DECLARATION DR, N, GREENWOOD, IN 46143-7283
- **Practice address phone:** (317) 886-7417
- **Practice address fax:** (317) 886-7671
- **Mailing address:** 11 DECLARATION DR, N, GREENWOOD, IN 46143-7283
- **Mailing address phone:** (317) 886-7417
- **Mailing address fax:** (317) 886-7681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 28084354 | IN | — |
| 207L00000X | Anesthesiology Physician | 01042621A | IN | — |
| 363LA2200X | Adult Health Nurse Practitioner | 71003812A | IN | Yes |
| 363LF0000X | Family Nurse Practitioner | 71000246A | IN | — |

## Other

- **Enumeration date:** 05/19/2011
- **Last updated:** 12/06/2011