Provider Demographics
NPI:1447043252
Name:XIONG, YA (NP)
Entity type:Individual
Prefix:
First Name:YA
Middle Name:
Last Name:XIONG
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 N BRIDGE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2105
Mailing Address - Country:US
Mailing Address - Phone:336-835-5330
Mailing Address - Fax:336-835-5337
Practice Address - Street 1:1925 N BRIDGE ST STE 101
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2105
Practice Address - Country:US
Practice Address - Phone:336-835-5330
Practice Address - Fax:336-835-5337
Is Sole Proprietor?:No
Enumeration Date:2025-05-24
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5022227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily