Provider Demographics
NPI:1215476320
Name:DE LA GARZA, SUMMER (NNP-BC)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6084 E 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-3310
Mailing Address - Country:US
Mailing Address - Phone:720-732-0181
Mailing Address - Fax:
Practice Address - Street 1:6084 E 62ND AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-3310
Practice Address - Country:US
Practice Address - Phone:720-732-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO162661163WN0002X
COAPN0993257-NP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care