Individual
MARY I. SUMMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
14 PLUMBER ST, WARREN, PA 16365-1202
(814) 723-2323
(814) 726-3337
Mailing address
14 PLUMBER ST, WARREN, PA 16365-1202
(814) 723-2323
(814) 726-3337
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
SP008969
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027486901
UNIVERA HEALTHCARE
PA
Enumeration date
06/16/2006
Last updated
03/22/2016
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