Andrea Lynne Grooms, PA-C
Physician Assistant, Medical in Smyrna, TN. Individual provider (NPI-1).
NPI number1023084019
StatusActive
Last updated in NPPESAug 1, 2023
Details
- NPI
- 1023084019
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Andrea Lynne Grooms
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 28, 2006
- Certification date
- Aug 1, 2023
- Last updated
- Aug 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 5109 | TN | Yes |
| 363A00000X | Physician Assistant | C5-0000860 | DE | |
| 363A00000X | Physician Assistant | MA051040 | PA | |
| 363A00000X | Physician Assistant | 5109 | TN | |
| 363AM0700X | Physician Assistant, Medical | MA051040 | PA | |
| 363AM0700X | Physician Assistant, Medical | OA003670 | PA |
Other names
- Andrea Drake Drake (Former Name)
Practice location
570 W. Sam Ridley PrkwySuite 102
Smyrna, TN 37167
Phone 615-984-2940 · Fax 614-984-2945
Mailing address
570 W. Sam Ridley PrkwySuite 102
Smyrna, TN 37167
Phone 615-984-2940 · Fax 614-984-2945
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