Provider Demographics
NPI:1366199473
Name:SUMMA HOLDING
Entity type:Organization
Organization Name:SUMMA HOLDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIBERTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:251-802-7678
Mailing Address - Street 1:111 WILD OAK DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7729
Mailing Address - Country:US
Mailing Address - Phone:251-802-7678
Mailing Address - Fax:
Practice Address - Street 1:1203 US HIGHWAY 98 STE 4F
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4255
Practice Address - Country:US
Practice Address - Phone:251-298-7458
Practice Address - Fax:866-422-7458
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMA HOLDING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Single Specialty