MEDICARE: MRS. CHRISTINE MURDOCH KHAN APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0995896-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114584729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE MURDOCH KHAN APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1465 KELLY JOHNSON BLVD STE 305
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3947
Country	:	US
Telephone Number	:	719-495-3359
Fax Number	:	719-691-7003

Provider Business Practice Location Address
First Line	:	1465 KELLY JOHNSON BLVD STE 320
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3947
Country	:	US
Telephone Number	:	719-495-3359
Fax Number	:	719-691-7003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	01/02/2025

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