Provider Demographics
NPI:1891491692
Name:CHIM, GABRIELA LOERA (RN)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:LOERA
Last Name:CHIM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2607 S 4TH AVE STE D6
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7372
Mailing Address - Country:US
Mailing Address - Phone:928-373-8487
Mailing Address - Fax:
Practice Address - Street 1:2607 S 4TH AVE STE D6
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7372
Practice Address - Country:US
Practice Address - Phone:928-373-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
AZ262384364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide