Individual
SUMMER NICOLE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18444 N 25TH AVE, SUITE 210, PHOENIX, AZ 85023-1261
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE, SUITE 310, PHOENIX, AZ 85023-1261
(623) 537-5600
(623) 537-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3514
AZ
363AM0700X
Medical Physician Assistant
3514
AZ
363AS0400X
Surgical Physician Assistant
Primary
3514
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143978
—
AZ
01
—
5550830001
MEDICARE NSC SCW
AZ
01
—
5550830003
MEDICARE NSC PEORIA
AZ
01
—
5550830004
MEDICARE NSC PV
AZ
01
—
5550830006
MEDICARE NSC ANTHEM
AZ
01
—
5550830007
MEDICARE NSC DV
AZ
01
—
5550830008
MEDICARE NSC SWV
AZ
01
—
5550830009
MEDICARE NSC AZ NORTH
AZ
01
—
5550830010
MEDICARE NSC GILBERT
AZ
Enumeration date
10/18/2006
Last updated
04/18/2024
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