Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | M250673 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | M250673 | CA |
N | 363LW0102X | Nurse Practitioner - Women's Health | M250673 | CA |
NPI | 1285182550 |
---|---|
Provider Name | Elizabeth Anne Summerhayes |
First Address | Lafayette, CA 94549-4933 |
Second Address | Lafayette, CA 94549-4933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2016 |
Last Update Date | 29/09/2016 |