Provider Demographics
NPI:1508427170
Name:GROOM, SUMMYJI (DNP, RN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SUMMYJI
Middle Name:
Last Name:GROOM
Suffix:
Gender:F
Credentials:DNP, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 GADSDEN HWY STE 116-618
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3103
Mailing Address - Country:US
Mailing Address - Phone:256-467-7279
Mailing Address - Fax:801-683-1907
Practice Address - Street 1:1430 GADSDEN HWY STE 116-618
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3103
Practice Address - Country:US
Practice Address - Phone:256-467-7279
Practice Address - Fax:801-683-1907
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131786363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health