Individual provider Active NPI

Kimberli Jo Galloway, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cornville, AZ
National Provider Identifier
1831506922
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
342002 Issued in AZ
Practice address
965 S Desert View Dr
Cornville, AZ 86325-4999
Phone
(760) 271-3603
NPI assigned
Jul 21, 2014
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 342002 AZ Primary
Registered Nurse 163W00000X 28201347A IN
Registered Nurse 163W00000X 803891 CA
Registered Nurse 163W00000X RN171759 AZ

Addresses

Primary practice location

965 S Desert View Dr
Cornville, AZ 86325-4999

Mailing address

965 S Desert View Dr
Cornville, AZ 86325-4999
Phone (760) 271-3603

Other practice location 1

185 Roadrunner Dr
Sedona, AZ 86336-3763
Phone (928) 282-3744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
803891CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1831506922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 S DESERT VIEW DR",
            "city": "CORNVILLE",
            "state": "AZ",
            "postal_code": "863254999",
            "telephone_number": "760-271-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 S DESERT VIEW DR",
            "city": "CORNVILLE",
            "state": "AZ",
            "postal_code": "863254999",
            "telephone_number": "760-271-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 Roadrunner Dr",
            "address_purpose": "LOCATION",
            "city": "Sedona",
            "state": "AZ",
            "postal_code": "863363763",
            "country_code": "US",
            "telephone_number": "928-282-3744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "KIMBERLI",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "342002",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28201347A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "803891",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN171759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornville, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.