MEDICARE: NAZNEEN KHAN

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	367A00000X	Advanced Practice Midwife	COA.00477-NM	OH

General Provider Information

NPI Number	:	1306256417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZNEEN KHAN

Provider Business Mailing Address
First Line	:	32810 CREEKSIDE DR
Second Line	:
City	:	PEPPER PIKE
State	:	OH
Zip	:	44124-5230
Country	:	US
Telephone Number	:	216-378-7187
Fax Number	:

Provider Business Practice Location Address
First Line	:	12000 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1922
Country	:	US
Telephone Number	:	216-991-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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Directions to “ NAZNEEN KHAN ” Practice Location

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