Individual
AMBER P GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
444 CLINCHFIELD ST STE 201, KINGSPORT, TN 37660-3863
(423) 230-2113
(423) 230-2112
Mailing address
2866 CARROLL CREEK RD, JOHNSON CITY, TN 37615-4541
(423) 439-4071
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2620
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2620
ST LIC
TN
Enumeration date
08/07/2013
Last updated
10/04/2018
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