Provider Demographics
NPI:1326867847
Name:KHAN, NABEELA MARYAM (RDN)
Entity type:Individual
Prefix:
First Name:NABEELA
Middle Name:MARYAM
Last Name:KHAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 MAGELLAN WAY APT 305
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2262
Mailing Address - Country:US
Mailing Address - Phone:763-321-0047
Mailing Address - Fax:
Practice Address - Street 1:5731 MAGELLAN WAY APT 305
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2262
Practice Address - Country:US
Practice Address - Phone:763-321-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL008191133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered