Provider Demographics
NPI:1235419268
Name:XIAO, LUCY (NP)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:XIAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 SAWGRASS LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7102
Mailing Address - Country:US
Mailing Address - Phone:540-840-8710
Mailing Address - Fax:
Practice Address - Street 1:3700 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-2050
Practice Address - Country:US
Practice Address - Phone:703-441-7511
Practice Address - Fax:703-441-7695
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001187672163W00000X
VA0024169457363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse