Provider Demographics
NPI:1871286914
Name:NUMANOVIC, NAIRA (PMHNP)
Entity type:Individual
Prefix:
First Name:NAIRA
Middle Name:
Last Name:NUMANOVIC
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S CHERRY ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1323
Mailing Address - Country:US
Mailing Address - Phone:720-796-4429
Mailing Address - Fax:
Practice Address - Street 1:501 S CHERRY ST STE 1100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1323
Practice Address - Country:US
Practice Address - Phone:720-796-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0100625-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health