Individual
MS. KHALIDA OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
50 E.168TH ST., BRONX, NY 10452-7929
(917) 862-5215
(718) 347-4643
Mailing address
PO BOX 491, NEW YORK, NY 10027-0491
(646) 279-4521
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
810664
NY
164W00000X
Licensed Practical Nurse
295252
NY
Other
Enumeration date
05/29/2011
Last updated
01/13/2022
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