Individual
LINDA SUMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 W CLAIBORNE AVE, GREENWOOD, MS 38930-2806
(662) 897-5157
Mailing address
1204 W CLAIBORNE AVE, GREENWOOD, MS 38930-2806
(662) 897-5157
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
39623
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-3691022
PRIVATE INSURANCE
MS
Enumeration date
11/07/2020
Last updated
11/07/2020
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