Healthcare Provider Details

I. General information

NPI: 1063228765
Provider Name (Legal Business Name): ABBY MARIE RAMBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8373 E VIA DE VENTURA APT J126
SCOTTSDALE AZ
85258-3154
US

IV. Provider business mailing address

8373 E VIA DE VENTURA APT J126
SCOTTSDALE AZ
85258-3154
US

V. Phone/Fax

Practice location:
  • Phone: 602-531-4098
  • Fax:
Mailing address:
  • Phone: 602-531-4098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11303
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: