Individual
MRS. NICOLE RAE SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2400 N WASHINGTON BLVD, NORTH OGDEN, UT 84414-7233
(801) 442-3059
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 442-3059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10232585-1204
UT
207Q00000X
Family Medicine Physician
8527A
WY
208D00000X
General Practice Physician
8527A
WY
Other
Enumeration date
11/03/2010
Last updated
07/21/2022
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