Provider Demographics
NPI:1154440147
Name:PRIEBE, CAMBRIA (OTR L)
Entity Type:Individual
Prefix:
First Name:CAMBRIA
Middle Name:
Last Name:PRIEBE
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 W MONTE CRISTO AVE APT 141
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3871
Mailing Address - Country:US
Mailing Address - Phone:602-427-8313
Mailing Address - Fax:
Practice Address - Street 1:3535 W MONTE CRISTO AVE APT 141
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3871
Practice Address - Country:US
Practice Address - Phone:602-427-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3155251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health