Healthcare Provider Details

I. General information

NPI: 1376619957
Provider Name (Legal Business Name): ARUNA NAMMI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 REGENCY CT STE 200
BROOKFIELD WI
53045-6195
US

IV. Provider business mailing address

19385 BUCKINGHAM PL
BROOKFIELD WI
53045-6200
US

V. Phone/Fax

Practice location:
  • Phone: 262-955-6601
  • Fax: 888-971-4145
Mailing address:
  • Phone: 414-731-0749
  • Fax: 888-971-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number49817-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number49817-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number49817-20
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number49817-20
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number49817-020
License Number StateWI
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number49817-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: