Provider Demographics
NPI:1740176338
Name:SHENOUDA, HELEN MALAK YOUSSEF
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:MALAK YOUSSEF
Last Name:SHENOUDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2138
Mailing Address - Country:US
Mailing Address - Phone:970-530-2105
Mailing Address - Fax:
Practice Address - Street 1:2614 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2138
Practice Address - Country:US
Practice Address - Phone:970-530-2105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0025188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist