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

Mamoona Hameed Khan

Individual provider Registered Nurse · NPI 1902411259

Mamoona Hameed Khan is a Nurse Practitioner in Canton, Michigan. Qualified in 2024, 2 years ago. Licensed in Michigan and Texas.

Years since qualifying
2
Licensed in
MI, TX
In the registry since
2020
Specialties on file
2

Practice location Address checks out

43825 Michigan Ave
Canton, MI 48188-2551
Phone: (734) 397-3088
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 1075815 (TX)
Registered Nurse Taxonomy 163W00000X · Licence 4704365990 (MI)

Record details

NPI number1902411259
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 14, 2020
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Canton