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General NPI Number Information
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NPI Number | 1194492306
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Entity Type | Individual
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Provider Name | DEBORAH A GOROMBEI FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 16515 S 40TH ST STE 143
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City | PHOENIX
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State | AZ
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Zip | 85048-0560
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Country | US
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Telephone | 480-712-1305
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Fax |
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Provider Business Mailing Address
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Address Line | 4939 W RAY RD # 4-118
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City | CHANDLER
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State | AZ
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Zip | 85226-2065
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Country | US
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Telephone | 602-550-5566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 262885
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | TEMP262885
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License Number State | AZ
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