Provider Demographics
NPI:1831416189
Name:HINTHORNE, SUMMER ALYSSA (APN, WHNP)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:ALYSSA
Last Name:HINTHORNE
Suffix:
Gender:F
Credentials:APN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 JACOBSSEN DR STE B
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-5516
Mailing Address - Country:US
Mailing Address - Phone:309-451-1123
Mailing Address - Fax:309-451-1212
Practice Address - Street 1:2200 JACOBSSEN DR STE B
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-5516
Practice Address - Country:US
Practice Address - Phone:309-451-1123
Practice Address - Fax:309-451-1212
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007775363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health