Provider Demographics
NPI:1386425767
Name:KHAN, SOFIA YUNAS (FNP)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:YUNAS
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 1:2200 OPITZ BLVD STE 355
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3340
Mailing Address - Country:US
Mailing Address - Phone:703-580-6400
Mailing Address - Fax:
Practice Address - Street 1:2200 OPITZ BLVD STE 355
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3340
Practice Address - Country:US
Practice Address - Phone:703-580-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily