Basic Information
Provider Information
NPI: 1316040454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMBLER
FirstName: TONYA
MiddleName: S.
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 W BAXTER AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379216851
CountryCode: US
TelephoneNumber: 8652731752
FaxNumber: 8652731755
Practice Location
Address1: 7123 GRIZZLY CREEK LN
Address2:  
City: POWELL
State: TN
PostalCode: 378494540
CountryCode: US
TelephoneNumber: 8652561868
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/06/2006
LastUpdateDate: 02/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X119817TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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