Provider Demographics
NPI:1851537799
Name:YUAN, XING PENG (RNSA)
Entity Type:Individual
Prefix:MR
First Name:XING
Middle Name:PENG
Last Name:YUAN
Suffix:
Gender:M
Credentials:RNSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 YOAKUM PKWY
Mailing Address - Street 2:# 1016
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3800
Mailing Address - Country:US
Mailing Address - Phone:703-888-0217
Mailing Address - Fax:703-286-7514
Practice Address - Street 1:205 YOAKUM PKWY
Practice Address - Street 2:# 1016
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3800
Practice Address - Country:US
Practice Address - Phone:703-888-0217
Practice Address - Fax:703-286-7514
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001141167163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant