MEDICARE: MYNDFUL WELLNESS LLC

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

General Provider Information

NPI Number	:	1376428185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYNDFUL WELLNESS LLC

Provider Business Mailing Address
First Line	:	2829 NORTH AVE # 102-3
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5368
Country	:	US
Telephone Number	:	970-549-2728
Fax Number	:	970-314-2436

Provider Business Practice Location Address
First Line	:	2829 NORTH AVE # 102-3
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5368
Country	:	US
Telephone Number	:	970-549-2728
Fax Number	:	970-314-2436

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA SCHMALZ
Credential	:	PMHNP-BC, RXN
Telephone Number	:	970-549-2728

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	10/15/2025

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