Provider Demographics
NPI:1356022941
Name:GEPHART, AMBER (FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GEPHART
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:DYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2706 COLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:FL
Mailing Address - Zip Code:33527-6364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 SEABOARD LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8281
Practice Address - Country:US
Practice Address - Phone:615-721-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023402363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner