Provider Demographics
NPI:1285092668
Name:XIONG, VICKI (RN)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:XIONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 GLOBE FLOWER CIR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1532
Mailing Address - Country:US
Mailing Address - Phone:612-251-4333
Mailing Address - Fax:
Practice Address - Street 1:3815 GLOBE FLOWER CIR N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1532
Practice Address - Country:US
Practice Address - Phone:612-251-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 214203-4163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health