MICHELLE SUMMERALL (NPI# 1578929147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578929147 |
| Entity Type | Individual |
| Full Name | MICHELLE SUMMERALL |
| Practice Address |
1650 South Beach Fort Worth TX 76104 |
| Mailing Address |
8910 San Benito Way Dallas TX 75218-4251 |
| Practice Telephone | 8177021100 |
| Mailing Telephone | 2148082709 |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
AP129835 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2727 Bolton Boone Drive, Suite 105, Desoto, TX 751154251 | 9722984300 |
| Street Address |
1650 SOUTH BEACH |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093734535 | Carla K Morrow | Nurse Practitioner | 622 Hemphill St, Fort Worth, TX 76104-3179 | 2006-07-18 |
| 1326030719 | Janice Maria Collins | Nurse Practitioner | 2900 Se Loop 820, Fort Worth, TX 76140-1013 | 2005-08-22 |
| 1528676400 | Kymberly Anett O'neal | Nurse Practitioner | 2900 Se Loop 820, Fort Worth, TX 76140-1013 | 2020-07-16 |
| 1073082533 | Abiena Cash | Nurse Practitioner | 2201 Se Loop 820, Fort Worth, TX 76119-5863 | 2018-11-14 |
| 1316457278 | Jamie Renee Shields | Nurse Practitioner | 2200 Ephriham Ave, Fort Worth, TX 76164-6642 | 2017-10-05 |
| 1235581372 | Sarah Elizabeth Clifford | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2016-07-12 |
| 1588076483 | Ann Palagi-pate | Nurse Practitioner | 1201 S Main St, Fort Worth, TX 76104-4804 | 2014-05-27 |
| 1508290057 | Carol Ann May | Nurse Practitioner | 855 Montgomery St, Dept of Ob/gyn, Fort Worth, TX 76107-2553 | 2013-09-02 |
| 1912217662 | Angela Mardine George | Nurse Practitioner | 4312 Heritage Trace Pkwy, Suite 700, Fort Worth, TX 76244-9132 | 2010-10-15 |
| 1164666517 | Dora Linda Bradford | Nurse Practitioner | 2106 N Main St, Fort Worth, TX 76164-8511 | 2009-04-29 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on MICHELLE SUMMERALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.