Grimball, Andrea Tomasek

Grimball, Andrea Tomasek is an individual health care provider with primary practice located at 27 Medical Center Dr , Jackson TN 38301-3949. 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. Grimball, Andrea Tomasek can be contacted via phone (731) 424-1001.

Contact Information

Primary practice address
27 Medical Center Dr Jackson TN 38301-3949
Phone: (731) 424-1001
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9101918 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA0000001561 Tennessee

Profile Details

NPI number 1427144997
LBN Legal business name Grimball, Andrea Tomasek
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Mar 24th, 2009 - about 15 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 1427144997 NPPES
Alabama Other 059051687 BCBS OF ALABAMA
Alabama Other 970023893 BCBS OF ALABAMA
Alabama MEDICAID 291182500 BCBS OF ALABAMA
Alabama MEDICAID 009976550 BCBS OF ALABAMA

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