# DR. KHAIRUNNISSA JOOMA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639102791
- **Gender:** F
- **Credential:** DNP/PMHNP-BC/LPC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | LPC 1953 | TN | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APN0000013348 | TN | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 12/06/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5441854 | — | TN |
| 01 | — | P00967911 | RAILROAD MEDICARE | TN |