Individual
MRS. ANDREA LYNNE GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
570 W. SAM RIDLEY PRKWY, SUITE 102, SMYRNA, TN 37167
(615) 984-2940
(614) 984-2945
Mailing address
570 W. SAM RIDLEY PRKWY, SUITE 102, SMYRNA, TN 37167
(615) 984-2940
(614) 984-2945
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5109
TN
363A00000X
Physician Assistant
C5-0000860
DE
363A00000X
Physician Assistant
MA051040
PA
363AM0700X
Medical Physician Assistant
Primary
5109
TN
363AM0700X
Medical Physician Assistant
MA051040
PA
363AM0700X
Medical Physician Assistant
OA003670
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023084019
—
DE
Enumeration date
02/28/2006
Last updated
08/01/2023
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