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General NPI Number Information
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NPI Number | 1033745047
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Entity Type | Individual
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Provider Name | FELISTIA NICOLE GAMBILL MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2020
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 1817 W MORRIS BLVD
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City | MORRISTOWN
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State | TN
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Zip | 37813-2837
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Country | US
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Telephone | 423-581-3904
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 DICK LONAS RD UNIT 101
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City | KNOXVILLE
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State | TN
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Zip | 37909-1383
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Country | US
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Telephone | 865-584-4747
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD482027
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 73129
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License Number State | TN
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