Individual
KELLY MARIE SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
ARNP9311879
FL
363L00000X
Nurse Practitioner
Primary
ARNP9311879
FL
Other
Enumeration date
07/21/2017
Last updated
10/13/2017
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