MEDICARE: AMY LYN GROBSTICK ARNP

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	208VP0014X	Interventional Pain Medicine Physician	APRN9315700	FL
2	363L00000X	Nurse Practitioner	A114736	IA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9315700	FL
4	207R00000X	Internal Medicine Physician	APRN9315700	FL
5	363L00000X	Nurse Practitioner	4704320850	MI
6	363LF0000X	Family Nurse Practitioner	ARNP9315700	FL
7	363L00000X	Nurse Practitioner	9315700	FL
8	363LP2300X	Primary Care Nurse Practitioner	ARNP9315700	FL
9	2084N0400X	Neurology Physician	APRN9315700	FL
10	207R00000X	Internal Medicine Physician	9315700	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881995140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LYN GROBSTICK ARNP

Provider Business Mailing Address
First Line	:	868 SHORELINE CIR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2741
Country	:	US
Telephone Number	:	904-866-9551
Fax Number	:	570-554-8214

Provider Business Practice Location Address
First Line	:	868 SHORELINE CIR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2741
Country	:	US
Telephone Number	:	904-866-9551
Fax Number	:	904-542-7346

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

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	05/16/2026

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