Individual
BETH PEMBROKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16620 N 40TH ST STE E-1, PHOENIX, AZ 85032-3348
(602) 464-9576
(602) 626-8901
Mailing address
4531 N 16TH ST STE 114, PHOENIX, AZ 85016-5344
(602) 464-9576
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
13987096-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
271416
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
79497
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
C-APN.0102379-C-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F405679-01
NY
Other
Enumeration date
01/29/2018
Last updated
07/01/2025
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