Provider Demographics
NPI:1417033044
Name:KHAN, LUBNA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUBNA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N. GREEN VALLEY PARKWAY SUITE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074
Mailing Address - Country:US
Mailing Address - Phone:702-436-7700
Mailing Address - Fax:702-436-3800
Practice Address - Street 1:100 N GREEN VALLEY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6392
Practice Address - Country:US
Practice Address - Phone:702-436-7700
Practice Address - Fax:702-436-3800
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49768207Q00000X
NV12904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1417033044Medicaid
NV12904OtherSTATE LICENSE