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General NPI Number Information
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NPI Number | 1669761680
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Entity Type | Individual
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Provider Name | JENNIFER P ROOP PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 11416 GRIGSBY CHAPEL RD STE 100
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City | KNOXVILLE
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State | TN
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Zip | 37934-1649
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Country | US
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Telephone | 865-675-8000
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Fax | 865-524-0224
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Provider Business Mailing Address
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Address Line | 1306 CONCOURSE DR STE 201
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City | LINTHICUM HEIGHTS
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State | MD
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Zip | 21090-1033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9105939
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3617
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License Number State | TN
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