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General NPI Number Information
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NPI Number | 1598276446
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Entity Type | Individual
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Provider Name | SADIA MAHMOOD KHAN APRN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 1035 PLACER ST
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City | REDDING
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State | CA
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Zip | 96001-1125
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Country | US
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Telephone | 530-246-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 851 MISSION DE ORO DR APT 99
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City | REDDING
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State | CA
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Zip | 96003-5048
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Country | US
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Telephone | 203-747-2509
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95124915
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 101125
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License Number State | CT
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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 | 95007715
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License Number State | CA
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