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1679090187
JENNIFER DIANE KHAN
JOHNSON CITY, NY
NPI
1679090187
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Former Name
JENNIFER DIANE LAKE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 341927)
Enumeration Date
2017-08-25
Last Update Date
2023-08-07
Business Address
JENNIFER DIANE KHAN NP
33-57 HARRISON ST
JOHNSON CITY, NY 13790-2107
Phone number: 607-763-6638
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Mailing Address
JENNIFER DIANE KHAN NP
26 JOHNSON AVE
BINGHAMTON, NY 13905-4341
Phone number: 607-206-3147
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