Provider Demographics
NPI:1962107953
Name:PATEL, KHUSBU (NP)
Entity type:Individual
Prefix:
First Name:KHUSBU
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:771 OLD NORCROSS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4980
Mailing Address - Country:US
Mailing Address - Phone:770-339-1387
Mailing Address - Fax:770-962-7868
Practice Address - Street 1:771 OLD NORCROSS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4980
Practice Address - Country:US
Practice Address - Phone:770-339-1387
Practice Address - Fax:770-962-7868
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN291127363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology