MEDICARE: MARIA WILMA BRUNA SOMBILLA MSN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM1400X	Nurse Massage Therapist (NMT)	RN144884	AZ

General Provider Information

NPI Number	:	1629928098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA WILMA BRUNA SOMBILLA MSN RN

Provider Business Mailing Address
First Line	:	16234 N 1ST DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-7480
Country	:	US
Telephone Number	:	480-806-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	16234 N 1ST DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-7480
Country	:	US
Telephone Number	:	480-806-7755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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