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General NPI Number Information
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NPI Number | 1861849457
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Entity Type | Individual
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Provider Name | THOMAS NOLAN GROFF FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 12007 SUNRISE VALLEY DR STE 120
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City | RESTON
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State | VA
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Zip | 20191-3460
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Country | US
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Telephone | 703-522-2089
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Fax |
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Provider Business Mailing Address
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Address Line | 8160 VETERANS PKWY APT 1434
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City | COLUMBUS
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State | GA
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Zip | 31909-1980
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Country | US
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Telephone | 703-624-0749
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 674198-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F339851-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC007554
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024189953
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License Number State | VA
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