Healthcare Provider Details

I. General information

NPI: 1134557218
Provider Name (Legal Business Name): AMBER GASKINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2013
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 STEWART LN
LOUISVILLE TN
37777-4135
US

IV. Provider business mailing address

PO BOX 5777
MARYVILLE TN
37802-5777
US

V. Phone/Fax

Practice location:
  • Phone: 865-980-5200
  • Fax: 865-246-2106
Mailing address:
  • Phone: 865-246-2104
  • Fax: 865-246-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0000018059
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0000018059
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: