Individual
REGINA SUMNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
167 NORTH MAIN, TUBA CITY, AZ 86045
(928) 283-2501
Mailing address
P.O. BOX 1698, TUBA CITY, AZ 86045-1698
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L11485
ND
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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