Provider Demographics
NPI:1952569345
Name:GRUMMON, RUPA MEENA (MSN NP-C)
Entity Type:Individual
Prefix:MRS
First Name:RUPA
Middle Name:MEENA
Last Name:GRUMMON
Suffix:
Gender:F
Credentials:MSN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 ROLLING FORK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5919
Mailing Address - Country:US
Mailing Address - Phone:615-927-6132
Mailing Address - Fax:
Practice Address - Street 1:4200 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2789
Practice Address - Country:US
Practice Address - Phone:615-501-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA1207165363LA2200X
TNG0408096363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology