Individual
MICHELLE SUMMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5808 W. 110TH ST., OVERLAND PARK, KS 64211
(913) 696-8000
Mailing address
2401 GILLHAM ROAD, KANSAS CITY, MO 64108-4619
(816) 234-9227
(816) 234-9295
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
671
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002001088
STATE LICENSE
MO
01
—
671
STATE LICENSE
KS
Enumeration date
01/16/2009
Last updated
01/16/2009
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