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1679724439 NPI number — AMBREEN NASIR KHAN MD

NPI Number: 1679724439
Health Care Provider/Practitioner: AMBREEN NASIR KHAN MD

Information about “1679724439” NPI (AMBREEN NASIR KHAN MD) exists in 1679724439 in HTML format HTML  |  1679724439 in plain Text format TXT  |  1679724439 in PDF (Portable Document Format) PDF  |  1679724439 in an XML format XML  formats.

NPI Number : 1679724439 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679724439",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KHAN",
    "FirstName": "AMBREEN",
    "MiddleName": "NASIR",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NASIR",
    "OtherFirstName": "AMBREEN",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "15741 MOHAWK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OVERLAND PARK",
    "MailingAddressStateName": "KS",
    "MailingAddressPostalCode": "66224-3828",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "913-638-0243",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7800 W 110TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OVERLAND PARK",
    "PracticeLocationAddressStateName": "KS",
    "PracticeLocationAddressPostalCode": "66210-2304",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "913-339-0306",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/09/2008",
    "LastUpdateDate": "12/13/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207ZP0102X",
          "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
          "LicenseNumber": "041229",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ZP0102X",
          "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
          "LicenseNumber": "2008021136",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ZP0102X",
          "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
          "LicenseNumber": "04-34153",
          "LicenseNumberStateCode": "KS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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