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Individual
KEVIN L GROOMS
Active
Individual
KEVIN L GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1076162
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167059
—
AL
01
—
511-55403
BLUE CROSS OF ALABAMA
AL
Enumeration date
06/17/2011
Last updated
12/07/2015
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