MEDICARE: SHAMIM NAMAKULA PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0997434	CO

General Provider Information

NPI Number	:	1922740083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMIM NAMAKULA PMHNP

Provider Business Mailing Address
First Line	:	8821 E HAMPDEN AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-4959
Country	:	US
Telephone Number	:	702-589-4871
Fax Number	:	844-287-2299

Provider Business Practice Location Address
First Line	:	8821 E HAMPDEN AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-4959
Country	:	US
Telephone Number	:	720-949-3125
Fax Number	:	844-287-2299

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

Provider Enumeration Date	:	04/10/2022
Last Update Date	:	06/10/2026

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