Individual
KIMBERLY GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
950 E MAIN ST BLDG B, SOMERTON, AZ 85350-7409
(928) 236-8001
(928) 722-6113
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
(928) 722-6113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
254402
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
254402
AZ STATE LICENSE
AZ
Enumeration date
02/22/2021
Last updated
08/13/2024
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