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General NPI Number Information
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NPI Number | 1144573056
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Entity Type | Individual
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Provider Name | SOPHIA ANNEMARIE KHAWLY NP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 24 N WESTFIELD ST
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City | FEEDING HILLS
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State | MA
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Zip | 01030-1606
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Country | US
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Telephone | 413-831-7831
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Fax |
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Provider Business Mailing Address
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Address Line | 1395 NW 167TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5710
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Country | US
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Telephone | 941-357-7950
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Fax | 941-840-1003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0029313
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9323668
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10006540
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License Number State | MA
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