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

Mrs. Lynnette Michelle Khandaker, APRN-NP

Individual provider General Practice Registered Nurse · NPI 1396292421

Mrs. Lynnette Michelle Khandaker, APRN-NP is a Nurse Practitioner in Boise, Idaho. Qualified in 2016, 10 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Arizona and Idaho.

Years since qualifying
10
Licensed in
AZ, ID
In the registry since
2016
Specialties on file
5
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Practice location Address checks out

10112 W Overland Rd
Boise, ID 83709-1428
Phone: (087) 803-9002
Fax: (208) 375-2882
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 60046 (ID)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence RN201537 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence NP60046 (ID)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 60046 (ID)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 60046 (ID)

Record details

NPI number1396292421
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-NP
Sole proprietorYes
NPI enumeratedSeptember 7, 2016
Last updated in NPPESJuly 16, 2021
Certification dateJuly 16, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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