Healthcare Provider Details

I. General information

NPI: 1902729841
Provider Name (Legal Business Name): SHOBHANA NAKUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 S UNIVERSITY BLVD STE 140
HIGHLANDS RANCH CO
80126-5049
US

IV. Provider business mailing address

6606 GREEN RIVER DR UNIT G
HIGHLANDS RANCH CO
80130-6729
US

V. Phone/Fax

Practice location:
  • Phone: 303-471-4506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0020169
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: