Healthcare Provider Details

I. General information

NPI: 1053956037
Provider Name (Legal Business Name): NUSHEEN KHAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 BURNS RD STE 302
PALM BEACH GARDENS FL
33410-4321
US

IV. Provider business mailing address

1411 N FLAGLER DR STE 6800
WEST PALM BEACH FL
33401-3417
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-7661
  • Fax: 561-622-4651
Mailing address:
  • Phone: 561-832-0283
  • Fax: 561-832-7955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11004503
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: