Provider Demographics
NPI:1003319864
Name:XIONG, KARSON NEEJZOO
Entity Type:Individual
Prefix:
First Name:KARSON
Middle Name:NEEJZOO
Last Name:XIONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 RICE ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3716
Mailing Address - Country:US
Mailing Address - Phone:651-298-9700
Mailing Address - Fax:651-298-9702
Practice Address - Street 1:2571 RICE ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3716
Practice Address - Country:US
Practice Address - Phone:651-298-9700
Practice Address - Fax:651-298-9702
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide