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NPI Code Detail

MEDICARE: SALENA KHAN

MEDICARE: SALENA KHAN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner333806AZ

General Provider Information

NPI Number : 1356282917
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALENA KHAN
Provider Business Mailing Address
First Line : 1910 S STAPLEY DR STE 221
Second Line :
City : MESA
State : AZ
Zip : 85204-6680
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1910 S STAPLEY DR STE 221
Second Line :
City : MESA
State : AZ
Zip : 85204-6680
Country : US
Telephone Number : 602-688-4191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ SALENA KHAN ” Practice Location

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