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Individual

JESSICA L KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2620 EAGAN WOODS DR STE 300, EAGAN, MN 55121-1138
(651) 968-5240
Mailing address
2620 EAGAN WOODS DR STE 300, EAGAN, MN 55121-1138
(651) 968-5240

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 160103-9
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
Enumeration date
04/23/2008
Last updated
08/23/2019
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