Provider Demographics
NPI:1265803514
Name:KHALID, FAUZIA (NP)
Entity type:Individual
Prefix:
First Name:FAUZIA
Middle Name:
Last Name:KHALID
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:FAUZIA
Other - Middle Name:
Other - Last Name:SHARIF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1439 CHARLOTTESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6658
Mailing Address - Country:US
Mailing Address - Phone:865-567-2862
Mailing Address - Fax:
Practice Address - Street 1:1439 CHARLOTTESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6658
Practice Address - Country:US
Practice Address - Phone:865-567-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003678363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics