Provider Demographics
NPI:1104700855
Name:PECK-HAINES, SUMMER ELIZABETH
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:ELIZABETH
Last Name:PECK-HAINES
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 1:136 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-1168
Mailing Address - Country:US
Mailing Address - Phone:724-992-5669
Mailing Address - Fax:
Practice Address - Street 1:4313 S PLEASANT CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1347
Practice Address - Country:US
Practice Address - Phone:479-341-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR234337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty