Provider Demographics
NPI:1740172709
Name:GAMBLIN, AMBER DAWN (NP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:GAMBLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 ROSEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2617
Mailing Address - Country:US
Mailing Address - Phone:573-864-1537
Mailing Address - Fax:
Practice Address - Street 1:922 ROSEDALE AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2617
Practice Address - Country:US
Practice Address - Phone:573-864-1537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN250939163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse