Healthcare Provider Details

I. General information

NPI: 1326478017
Provider Name (Legal Business Name): KIMBERLI BRUCE ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 W FRYE RD
CHANDLER AZ
85224-6282
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-3000
  • Fax: 480-728-4747
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP5272
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: