Provider Demographics
NPI:1720892243
Name:RADER, SUMMER (FNP)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:RADER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 RAY PERMENTER RD
Mailing Address - Street 2:
Mailing Address - City:BELLS
Mailing Address - State:TN
Mailing Address - Zip Code:38006-3855
Mailing Address - Country:US
Mailing Address - Phone:731-618-9171
Mailing Address - Fax:
Practice Address - Street 1:1072 RAY PERMENTER RD
Practice Address - Street 2:
Practice Address - City:BELLS
Practice Address - State:TN
Practice Address - Zip Code:38006-3855
Practice Address - Country:US
Practice Address - Phone:731-618-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily