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Individual

KEVIN L GROOMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
5947 HIGHWAY 269, PARRISH, AL 35580
(205) 686-5113
(205) 686-5145
Mailing address
5947 HIGHWAY 269, PARRISH, AL 35580
(205) 686-5113
(205) 686-5145

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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