Provider Demographics
NPI:1699030247
Name:XIONG, CHU (RN)
Entity Type:Individual
Prefix:
First Name:CHU
Middle Name:
Last Name:XIONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 BEARD AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-4211
Mailing Address - Country:US
Mailing Address - Phone:763-354-9667
Mailing Address - Fax:
Practice Address - Street 1:1049 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-3840
Practice Address - Country:US
Practice Address - Phone:651-793-7635
Practice Address - Fax:651-793-7659
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN206691-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse