Individual
SUMMER MICHELE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7345
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
724311
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP118982
TX
363LP0222X
Critical Care Pediatric Nurse Practitioner
724311
TX
Other
Enumeration date
10/19/2010
Last updated
04/10/2024
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