MEDICARE: HROKUKU P. V MIMBAR 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	SP033630	PA

General Provider Information

NPI Number	:	1972475713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HROKUKU P. V MIMBAR PMHNP

Provider Business Mailing Address
First Line	:	4387 W SWAMP RD # 599
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18902-1039
Country	:	US
Telephone Number	:	455-530-9128
Fax Number	:

Provider Business Practice Location Address
First Line	:	4387 W SWAMP RD # 599
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18902-1039
Country	:	US
Telephone Number	:	455-530-9128
Fax Number	:

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

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	02/23/2026

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