Provider Demographics
NPI:1457107880
Name:SUMNER, ANGELA JEAN (RD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JEAN
Last Name:SUMNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 GRAYLYN CREST DR
Mailing Address - Street 2:
Mailing Address - City:NEW COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17856-9416
Mailing Address - Country:US
Mailing Address - Phone:570-492-0567
Mailing Address - Fax:
Practice Address - Street 1:53 GRAYLYN CREST DR
Practice Address - Street 2:
Practice Address - City:NEW COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17856-9416
Practice Address - Country:US
Practice Address - Phone:570-492-0567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered