Individual
PATRICIA ALEXA SUMMERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
104 EAST HIGHWAY 60, MOUNTAIN VIEW, MO 65548-7381
(417) 934-2251
(417) 934-2871
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
129188
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669430575
—
MO
05
—
428643639
—
MO
01
—
P00852026
PALMETTO GBA/RR MEDICARE
MO
Enumeration date
05/02/2006
Last updated
03/26/2014
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