Provider Demographics
NPI:1538022033
Name:DENHAM, KIMBERLY DESEREE (PMHNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DESEREE
Last Name:DENHAM
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13234 W BERRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-7308
Mailing Address - Country:US
Mailing Address - Phone:602-657-8462
Mailing Address - Fax:
Practice Address - Street 1:4527 N 16TH ST STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5352
Practice Address - Country:US
Practice Address - Phone:602-657-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ330310363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health