MEDICARE: AMBER GEPHART FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN11023402	FL

General Provider Information

NPI Number	:	1356022941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER GEPHART FNP-C

Provider Business Mailing Address
First Line	:	2706 COLEWOOD LN
Second Line	:
City	:	DOVER
State	:	FL
Zip	:	33527-6364
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 SEABOARD LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8281
Country	:	US
Telephone Number	:	615-721-7020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	07/27/2023

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