Provider Demographics
NPI:1497369219
Name:KHAN, FARHEEN IRENE (APRN-RNP)
Entity Type:Individual
Prefix:MRS
First Name:FARHEEN
Middle Name:IRENE
Last Name:KHAN
Suffix:
Gender:F
Credentials:APRN-RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 E KIMBALL CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9429
Mailing Address - Country:US
Mailing Address - Phone:480-388-5569
Mailing Address - Fax:
Practice Address - Street 1:1720 E BOSTON ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6226
Practice Address - Country:US
Practice Address - Phone:480-745-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN138124163W00000X
AZ246773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty