MEDICARE: POONGUZHALI RANGASWAMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN.0996210-NP	CO
2	363LF0000X	Family Nurse Practitioner	0996210	CO

General Provider Information

NPI Number	:	1720652381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POONGUZHALI RANGASWAMY

Provider Business Mailing Address
First Line	:	4809 ARGONNE ST STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6836
Country	:	US
Telephone Number	:	303-649-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	4809 ARGONNE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6834
Country	:	US
Telephone Number	:	303-649-3750
Fax Number	:	303-649-3751

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	06/04/2026

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Directions to “ POONGUZHALI RANGASWAMY ” Practice Location

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