Individual
MARLENE M SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
449 SE BAYA DRIVE, LAKE CITY, FL 32025
(386) 755-0500
(386) 755-9217
Mailing address
6400 W NEWBERRY RD, STE 207, GAINESVILLE, FL 32605-6600
(352) 371-2011
(352) 384-3611
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
1370482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240386
AVMED
FL
05
—
340059000
—
FL
01
—
Y9008
BCBS PROVIDER NUMBER
FL
Enumeration date
10/03/2006
Last updated
10/12/2016
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