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Individual
AMANDA LEE GROOME
Active
Individual
AMANDA LEE GROOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
19644
SC
363LP2300X
Primary Care Nurse Practitioner
Primary
19644
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3381
—
SC
Enumeration date
10/27/2010
Last updated
11/30/2021
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