Grooms, Lisa Anne

Grooms, Lisa Anne is an individual health care provider with primary practice located at 4532 Plank Rd , Fredericksburg VA 22407-0139. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Grooms, Lisa Anne can be contacted via phone (540) 252-1840.

Contact Information

Primary practice address
4532 Plank Rd Fredericksburg VA 22407-0139
Phone: (540) 252-1840
Fax: (540) 252-1841
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110002015 Virginia

Profile Details

NPI number 1821018219
LBN Legal business name Grooms, Lisa Anne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Nov 28th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821018219 NPPES
Virginia Other 540896390 TRICARE
Virginia MEDICAID 1821018219 TRICARE

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