MEDICARE: MS. MADHURI KHADKA NP

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	363L00000X	Nurse Practitioner	23897	SC
2	363LF0000X	Family Nurse Practitioner	23897	SC
3	363A00000X	Physician Assistant	5013996	NC

General Provider Information

NPI Number	:	1710591706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MADHURI KHADKA NP

Provider Business Mailing Address
First Line	:	PO BOX 601843
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-1843
Country	:	US
Telephone Number	:	704-243-8937
Fax Number	:	704-243-8926

Provider Business Practice Location Address
First Line	:	15235 JOHN J DELANEY DR STE B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2846
Country	:	US
Telephone Number	:	704-243-8937
Fax Number	:	704-243-8926

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

Provider Enumeration Date	:	09/07/2020
Last Update Date	:	01/30/2026

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