Provider Demographics
NPI:1144686692
Name:XIONG, DOUACHEE
Entity type:Individual
Prefix:
First Name:DOUACHEE
Middle Name:
Last Name:XIONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SHAFER DR
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-4363
Mailing Address - Country:US
Mailing Address - Phone:608-658-9171
Mailing Address - Fax:
Practice Address - Street 1:2002 SHAFER DR
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-4363
Practice Address - Country:US
Practice Address - Phone:608-658-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318752164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse