Individual
CHRISSA MANYETTA SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5394
(309) 692-2538
Mailing address
8600 N. STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9506
(309) 692-5394
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41353190
IL
367500000X
Certified Registered Nurse Anesthetist
209009654
IL
Other
Enumeration date
04/30/2012
Last updated
09/06/2012
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