MEDICARE: AFRAH 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
1	363LF0000X	Family Nurse Practitioner	F03260148	GA

General Provider Information

NPI Number	:	1942148390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFRAH KHAN

Provider Business Mailing Address
First Line	:	3458 PALISADE PARK CT
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-6698
Country	:	US
Telephone Number	:	470-209-3586
Fax Number	:

Provider Business Practice Location Address
First Line	:	3458 PALISADE PARK CT
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-6698
Country	:	US
Telephone Number	:	470-209-3586
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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