Provider Demographics
NPI:1619687340
Name:STROOP, JENNIFER (PA)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:STROOP
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2106 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2208
Mailing Address - Country:US
Mailing Address - Phone:931-455-2045
Mailing Address - Fax:931-455-9960
Practice Address - Street 1:2106 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2208
Practice Address - Country:US
Practice Address - Phone:931-455-2045
Practice Address - Fax:931-455-9960
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant