Individual
BRENDAN KEVIN GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1109 W LAGUNA DR, TEMPE, AZ 85282-4633
(520) 780-4817
Mailing address
1109 W LAGUNA DR, TEMPE, AZ 85282-4633
(520) 780-4817
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN200847
AZ
Other
Enumeration date
09/02/2024
Last updated
09/02/2024
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