Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lyan Khanji, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1578417002

Lyan Khanji, AGACNP-BC is a Nurse Practitioner in Boston, Massachusetts. Qualified in 2025, 1 year ago. Licensed in Massachusetts.

Years since qualifying
1
Licensed in
MA
In the registry since
2026

Practice location Address checks out

55 Fruit St
Boston, MA 02114-2696
Phone: (781) 414-0011
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence RN2353430 (MA)

Record details

NPI number1578417002
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedFebruary 23, 2026
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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