Provider Demographics
NPI:1285263335
Name:MORAN, SUMMER LEIGH (NP)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:LEIGH
Last Name:MORAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:LEIGH
Other - Last Name:BEITEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:648 CLUTTS RD
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-9029
Mailing Address - Country:US
Mailing Address - Phone:256-426-9553
Mailing Address - Fax:
Practice Address - Street 1:8490 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9575
Practice Address - Country:US
Practice Address - Phone:256-724-3587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-150568363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner