Individual
AZIE JUDITH KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7211 208TH CIR N, FOREST LAKE, MN 55025-2903
(515) 918-3955
Mailing address
7211 208TH CIR N, FOREST LAKE, MN 55025-2903
(515) 918-3955
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8079
MN
Other
Enumeration date
04/10/2021
Last updated
04/10/2021
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