Provider Demographics
NPI:1881995140
Name:GROBSTICK, AMY LYN (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYN
Last Name:GROBSTICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 SHORELINE CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2741
Mailing Address - Country:US
Mailing Address - Phone:904-866-9551
Mailing Address - Fax:904-542-7346
Practice Address - Street 1:868 SHORELINE CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2741
Practice Address - Country:US
Practice Address - Phone:904-866-9551
Practice Address - Fax:904-542-7346
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA114736363L00000X
MI4704320850363L00000X
FLAPRN9315700207R00000X, 208VP0014X
FL9315700207R00000X
FLARNP9315700363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care