Provider Demographics
NPI:1154878007
Name:HUNTLEY-DALE, SUMMER LEEANNE (NP)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:LEEANNE
Last Name:HUNTLEY-DALE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:LEEANNE
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:828-587-6312
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:1998 HENDERSONVILLE RD
Practice Address - Street 2:STE 51
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2349
Practice Address - Country:US
Practice Address - Phone:828-693-9199
Practice Address - Fax:828-692-2487
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008898363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner