Provider Demographics
NPI:1972292712
Name:SOMMERS MCNARY, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SOMMERS MCNARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 BREEZY ACRES DR
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:VT
Mailing Address - Zip Code:05354-9606
Mailing Address - Country:US
Mailing Address - Phone:603-702-2062
Mailing Address - Fax:
Practice Address - Street 1:239 BREEZY ACRES DR
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:VT
Practice Address - Zip Code:05354-9606
Practice Address - Country:US
Practice Address - Phone:603-702-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2348577176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife