Individual
KENNETH NEMBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
13060 S SUNLAND GIN RD, ARIZONA CITY, AZ 85123-8448
(520) 387-5651
Mailing address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
10034566
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
240670
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240670
240670
—
Enumeration date
04/24/2020
Last updated
10/28/2025
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