Provider Demographics
NPI:1427437888
Name:STRICKLAND, SUMMER M (FNP)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:M
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:STARR
Other - Last Name:MCNEELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1094 BERMUDA RUN
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458
Mailing Address - Country:US
Mailing Address - Phone:912-681-3111
Mailing Address - Fax:912-681-3461
Practice Address - Street 1:1094 BERMUDA RUN
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458
Practice Address - Country:US
Practice Address - Phone:912-681-3111
Practice Address - Fax:912-681-3461
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN141776163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003185387AMedicaid