Provider Demographics
NPI:1851945356
Name:DAVIES, SUMMER BECKETT (RN, MSN, APRN)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:BECKETT
Last Name:DAVIES
Suffix:
Gender:F
Credentials:RN, MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 SMITHTOWN BYP
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5005
Mailing Address - Country:US
Mailing Address - Phone:631-979-8880
Mailing Address - Fax:
Practice Address - Street 1:5225 NESCONSET HWY STE 23
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2058
Practice Address - Country:US
Practice Address - Phone:631-473-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245829363LA2100X
NYF432320-01363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care