Provider Demographics
NPI:1194370015
Name:WILLIAMS, SUMMER SPIVEY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:SPIVEY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CHARLES JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-7656
Mailing Address - Country:US
Mailing Address - Phone:478-733-6542
Mailing Address - Fax:
Practice Address - Street 1:522 GREENWOOD ST STE A
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-1554
Practice Address - Country:US
Practice Address - Phone:770-872-3663
Practice Address - Fax:770-872-3665
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine