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Individual

MRS. JESSICA ELAINE KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
301 NW 82ND AVE, PLANTATION, FL 33324-1811
(954) 693-8160
Mailing address
851 TRAFALGAR CT STE 200E, MAITLAND, FL 32751-7420
(407) 667-0444
(407) 667-4338

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
20781
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9447736
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023205600
FL
Enumeration date
11/07/2015
Last updated
08/22/2019
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