Provider Demographics
NPI:1366068447
Name:SUMMERS, RACHEL BROOKE (CNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:BROOKE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:BROOKE
Other - Last Name:LANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6194 FM 328
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75949-3047
Mailing Address - Country:US
Mailing Address - Phone:936-366-3045
Mailing Address - Fax:
Practice Address - Street 1:106 N US HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:TX
Practice Address - Zip Code:75949-8910
Practice Address - Country:US
Practice Address - Phone:936-876-5719
Practice Address - Fax:936-876-3308
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily