Individual
KATHERINE ETHRIDGE SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
840 N OAK AVE, RULEVILLE, MS 38771-3227
(662) 756-4024
Mailing address
1110 DEERING ST, CLEVELAND, MS 38732-3127
(205) 382-0935
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
904945
MS
Other
Enumeration date
11/06/2019
Last updated
10/08/2021
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