Individual
MS. BONNIE J SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6000 BOND AVE, CENTREVILLE, IL 62207-2328
(618) 332-2740
(618) 337-6039
Mailing address
6000 BOND AVE, CENTREVILLE, IL 62207-2328
(618) 332-2740
(618) 332-8755
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209000301
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN209000301
ADV PRACTICE NURSE ID
IL
01
—
RN041-127414
REGISTERED NURSE ID
IL
Enumeration date
12/05/2005
Last updated
11/21/2011
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