Provider Demographics
NPI:1073280434
Name:KHAN, SIDRAH M (FNP)
Entity type:Individual
Prefix:
First Name:SIDRAH
Middle Name:M
Last Name:KHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 L ST NW STE 350
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5072
Mailing Address - Country:US
Mailing Address - Phone:202-296-4002
Mailing Address - Fax:240-403-7893
Practice Address - Street 1:1920 L ST NW STE 350
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5072
Practice Address - Country:US
Practice Address - Phone:916-267-7947
Practice Address - Fax:240-403-7893
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAF09210533363LF0000X
DCF09210533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily