Provider Demographics
NPI:1659712396
Name:NI, XIU WEN (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:XIU
Middle Name:WEN
Last Name:NI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:NI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:111 N BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2783
Mailing Address - Country:US
Mailing Address - Phone:501-225-0703
Mailing Address - Fax:
Practice Address - Street 1:111 N BOWMAN RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2783
Practice Address - Country:US
Practice Address - Phone:501-225-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist