Provider Demographics
NPI:1285197616
Name:SUMMERS, IRENE K (FNP-C)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:K
Last Name:SUMMERS
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 1:1420 N COOPER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-8530
Mailing Address - Country:US
Mailing Address - Phone:972-204-5805
Mailing Address - Fax:
Practice Address - Street 1:1420 N COOPER ST STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-8530
Practice Address - Country:US
Practice Address - Phone:972-204-5805
Practice Address - Fax:817-730-9321
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty