Healthcare Provider Details

I. General information

NPI: 1558914507
Provider Name (Legal Business Name): DEVON MARIE GOMPERTS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 W 16TH ST
YUMA AZ
85364-4430
US

IV. Provider business mailing address

10696 E 35TH PL
YUMA AZ
85365-6863
US

V. Phone/Fax

Practice location:
  • Phone: 928-363-3600
  • Fax:
Mailing address:
  • Phone: 214-449-7172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number286928
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP142006
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: