Provider Demographics
NPI:1407217458
Name:XIONG, MAI C (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MAI
Middle Name:C
Last Name:XIONG
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 SMITH AVE N
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2387
Mailing Address - Country:US
Mailing Address - Phone:651-220-6750
Mailing Address - Fax:651-220-6770
Practice Address - Street 1:347 SMITH AVE N
Practice Address - Street 2:SUITE 401
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2387
Practice Address - Country:US
Practice Address - Phone:651-220-6750
Practice Address - Fax:651-220-6770
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4273363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics