MEDICARE: YOKO KHAN APRN

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028763	OH
2	163W00000X	Registered Nurse	RN.412700	OH

General Provider Information

NPI Number	:	1417538596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOKO KHAN APRN

Provider Business Mailing Address
First Line	:	882 S HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-3003
Country	:	US
Telephone Number	:	614-235-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	882 S HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-3003
Country	:	US
Telephone Number	:	614-235-5555
Fax Number	:

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

Provider Enumeration Date	:	04/20/2021
Last Update Date	:	04/21/2021

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Directions to “ YOKO KHAN APRN” Practice Location

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