Organization
BLUE SKY PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH A NEMBU PMHNP (OWNER)
(817) 658-2216
Entity
Organization
Contact information
Practice address
2432 W PEORIA AVE STE 13421343, PHOENIX, AZ 85029-4726
(817) 658-2216
Mailing address
10553 W APPALOOSA TRL, CASA GRANDE, AZ 85194-7612
(817) 658-2216
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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