Healthcare Provider Details

I. General information

NPI: 1902711658
Provider Name (Legal Business Name): ADIBA KHAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 SECOND STREET PIKE
RICHBORO PA
18954-1863
US

IV. Provider business mailing address

1034 SECOND STREET PIKE
RICHBORO PA
18954-1863
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 215-322-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036479
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: