Healthcare Provider Details

I. General information

NPI: 1013857176
Provider Name (Legal Business Name): CHRISTINA KHOURI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 STARR RD
ROYAL OAK MI
48073-2100
US

IV. Provider business mailing address

5280 METRO PKWY
STERLING HEIGHTS MI
48310-4005
US

V. Phone/Fax

Practice location:
  • Phone: 248-288-9340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704364999
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: