Provider Demographics
NPI:1629837562
Name:XU, JINGJING (L,AC)
Entity Type:Individual
Prefix:
First Name:JINGJING
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 ROLLING VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3638
Mailing Address - Country:US
Mailing Address - Phone:443-805-4755
Mailing Address - Fax:
Practice Address - Street 1:1909 YORK RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4224
Practice Address - Country:US
Practice Address - Phone:443-805-4755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03076171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist