Individual
AYESHA KHALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
200 WEST HOSPITAL DRIVE, USPHS INDIAN HOSPITAL, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-3522
Mailing address
PO BOX 860, 200 WEST HOSPITAL DRIVE, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-3522
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1057193
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057193
RDA CERTIFICATION
—
Enumeration date
08/28/2012
Last updated
07/31/2014
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