Provider Demographics
NPI:1881296382
Name:SIMONE GABRIEL ENTERPRISES
Entity type:Organization
Organization Name:SIMONE GABRIEL ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-567-7856
Mailing Address - Street 1:15182 N 75TH AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4722
Mailing Address - Country:US
Mailing Address - Phone:602-567-7856
Mailing Address - Fax:833-449-5032
Practice Address - Street 1:15182 N 75TH AVE STE 180
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4722
Practice Address - Country:US
Practice Address - Phone:602-567-7856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty