OMAR JERICO GABRIEL


Address: 3204 Kiersten Ln, Kingman, AZ 86401-0609
Phone: 9282799387

OMAR JERICO GABRIEL (NPI# 1427401652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427401652
Entity Type Individual
Full Name OMAR JERICO GABRIEL
Credential ANP
Practice Address 3204 Kiersten Ln
Kingman
AZ 86401-0609
Practice Telephone 9282799387
Mailing Telephone 9282799387
Enumeration Date 2016-07-23
Last Update Date 2016-07-23
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
AP8848 AZ Physician Assistants & Advanced Practice Nursing Providers
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
AP8848 AZ Physician Assistants & Advanced Practice Nursing Providers
N 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP8848 AZ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3204 KIERSTEN LN
City KINGMAN
State AZ
Zip Code 86401-0609

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053858704 Robert Cole Nurse Practitioner 3545 Cheyenne Ave, King,an, AZ 86401 2017-01-19
1710420286 Acadia Healthcare Inc Nurse Practitioner 2699 E Andy Devine, Suite B, Kingman, AZ 86401 2016-11-30
1174079800 Kenneth Mcadow Physical Therapist 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 2016-09-01
1649659483 Tracie Hirz Case Manager/Care Coordinator 3656 Packsaddle Road, Kingman, AZ 86401 2015-05-27
1548657695 Chelsea Presbrey Family Medicine 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 2015-04-15
1649617226 Abubakr Abdelmunim Tagelsir Abdelaziz Internal Medicine 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 2013-05-23
1205173325 Patricia Jean Marko Social Worker 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 2013-01-09
1770835316 Hae Young Lee Dentist 2058 Maya Dr., Kingman, AZ 86401 2012-10-05
1255681623 Hilary Radler Specialist/Technologist 3033 Macdonald, Kingman, AZ 86401 2012-09-13
1477836880 Goodwill of Northern Arizona Exclusive Provider Organization 2369 Airway Avenue, Kingman, AZ 86401 2011-09-21
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1134746951 Leah Beth Richardson Nurse Practitioner 2970 N Litchfield Rd Ste 120, Goodyear, AZ 85395-7831 2020-06-27
1558985036 Amanda Stanford Nurse Practitioner 925 E Mc Dowell Rd, Phoenix, AZ 85006 2020-06-01
1073141529 Shannalee Senior Nurse Practitioner 12574 W Mazatzal Dr, Peoria, AZ 85383-0379 2020-03-31
1821621996 Healthy Scottsdale, LLC Nurse Practitioner 7534 E 2nd St Ste 101, Scottsdale, AZ 85251-4548 2020-02-18
1710522024 Kelsey Conrad Nurse Practitioner 1 E Lexington Ave Unit 1602, Phoenix, AZ 85012-4203 2019-11-11
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Competitor

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City KINGMAN
Zip Code 86401

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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