MEDICARE: LINDSEY ANNE KHABBAZA NP-C

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	COA.14657-NP	OH

General Provider Information

NPI Number	:	1952741852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ANNE KHABBAZA NP-C

Provider Business Mailing Address
First Line	:	6575 SUMMER WIND DR
Second Line	:
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-3365
Country	:	US
Telephone Number	:	330-519-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2449
Country	:	US
Telephone Number	:	216-381-4300
Fax Number	:

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

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	02/25/2016

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