Provider Demographics
NPI:1336421650
Name:GROOMS, KAREN ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:GROOMS
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:8301 HARCOURT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2081
Mailing Address - Country:US
Mailing Address - Phone:317-228-3393
Mailing Address - Fax:317-228-3397
Practice Address - Street 1:8301 HARCOURT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2081
Practice Address - Country:US
Practice Address - Phone:317-228-3393
Practice Address - Fax:317-228-3397
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71003657A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner