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NPI Code Detail

MEDICARE: AMBER GRAVITT NP

MEDICARE: AMBER GRAVITT NP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN260524GA

General Provider Information

NPI Number : 1790592855
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER GRAVITT NP
Provider Business Mailing Address
First Line : 225 W LINE ST STE 4
Second Line :
City : CALHOUN
State : GA
Zip : 30701-1837
Country : US
Telephone Number : 678-383-0636
Fax Number :
Provider Business Practice Location Address
First Line : 225 W LINE ST STE 4
Second Line :
City : CALHOUN
State : GA
Zip : 30701-1837
Country : US
Telephone Number : 678-383-0636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2024
Last Update Date : 03/17/2026

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