Provider Demographics
NPI:1558184630
Name:SMITH, SUMMER PARKMAN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:PARKMAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:SUMMER
Other - Middle Name:
Other - Last Name:PARKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 E CHEVES ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2617
Mailing Address - Country:US
Mailing Address - Phone:843-777-2000
Mailing Address - Fax:843-777-5465
Practice Address - Street 1:101 MCLEOD HEALTH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4477
Practice Address - Country:US
Practice Address - Phone:843-646-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC260484163WE0003X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WE0003XNursing Service ProvidersRegistered NurseEmergency