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).
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 |
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 |
Street Address |
3204 KIERSTEN LN |
City | KINGMAN |
State | AZ |
Zip Code | 86401-0609 |
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 |
Find all providers in zip 86401 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255947404 | Alyssa Marie Lehn | Nurse Practitioner | 7501 E Mcdowell Rd Apt 3167, Scottsdale, AZ 85257-3574 | 2020-09-22 |
1205440310 | Alexa Kucharo | Nurse Practitioner | 4111 N Drinkwater Blvd Apt B405, Scottsdale, AZ 85251-3658 | 2020-09-04 |
1942819230 | Care On Pllc | Nurse Practitioner | 7171 S 51 Ave, Phoenix, AZ 85339-2923 | 2020-07-23 |
1720605231 | Sadie Franco | Nurse Practitioner | 8581 N Rolling River Dr, Tucson, AZ 85743-1451 | 2020-06-30 |
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 |
1124662408 | Rayiom Health and Wellness, Inc | Nurse Practitioner | 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 | 2019-10-30 |
Find all providers with the same taxonomy |
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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.