Provider Demographics
NPI:1679724439
Name:KHAN, AMBREEN NASIR (MD)
Entity type:Individual
Prefix:DR
First Name:AMBREEN
Middle Name:NASIR
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBREEN
Other - Middle Name:
Other - Last Name:NASIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15741 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66224-3828
Mailing Address - Country:US
Mailing Address - Phone:913-638-0243
Mailing Address - Fax:
Practice Address - Street 1:7800 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2304
Practice Address - Country:US
Practice Address - Phone:913-339-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041229207ZP0102X
MO2008021136207ZP0102X
KS04-34153207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology