Provider Demographics
NPI:1336031707
Name:SUMMERS, ANGEL D (RN)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:D
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20458 SAUCIER ADVANCE RD
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-9630
Mailing Address - Country:US
Mailing Address - Phone:228-380-3747
Mailing Address - Fax:
Practice Address - Street 1:20458 SAUCIER ADVANCE RD
Practice Address - Street 2:
Practice Address - City:SAUCIER
Practice Address - State:MS
Practice Address - Zip Code:39574-9630
Practice Address - Country:US
Practice Address - Phone:228-380-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS869371163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice