Individual
BRENT LUSAMBA-KASENDE KAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
261 N ROOSEVELT AVE, CHANDLER, AZ 85226-2617
(801) 688-4952
Mailing address
6013 S REDWOOD RD, TAYLORSVILLE, UT 84123-5220
(801) 255-5131
(801) 658-0604
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363LF0000X
Family Nurse Practitioner
Primary
297664
AZ
Other
Enumeration date
05/30/2018
Last updated
09/26/2023
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