Provider Demographics
NPI:1295076677
Name:KHALIL, KAREN (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KHALIL
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-7289
Mailing Address - Country:US
Mailing Address - Phone:470-258-2491
Mailing Address - Fax:
Practice Address - Street 1:426 HARRISON RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-7289
Practice Address - Country:US
Practice Address - Phone:470-258-2491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN197582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily