Summer Taken Alive
Case Manager/Care Coordinator in Bismarck, ND(View on Map)
Full Name
Summer Taken Alive
NPI Number
1396335360
NPI Type
Individual Provider
Gender
Female
Enumeration Date
01/22/2021
Specialties
(Taxonomies)Code
171M00000X
172A00000X
174400000X
Primary Taxonomy
Yes
No
No
Contact
Information
Purpose
Mailing
Location
Address
4909 SHELBURNE ST
4909 SHELBURNE ST
City
Bismarck
Bismarck
State
ND
ND
Postal Code
58503-5605
58503-5605
Country
US
US
Telephone Number
N/A
(701) 223-2417
Identifiers
Identifier
1481505
1481709
Identifier State
ND
ND
Identifier Issuer
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/03/2021