Provider Demographics
NPI:1740670702
Name:XIONG, KELLY YIA (NP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:YIA
Last Name:XIONG
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:16405 NORTHCROSS DR
Mailing Address - Street 2:STE G2
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5005
Mailing Address - Country:US
Mailing Address - Phone:704-334-7311
Mailing Address - Fax:704-335-9790
Practice Address - Street 1:1900 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6046
Practice Address - Country:US
Practice Address - Phone:704-334-7311
Practice Address - Fax:704-335-9790
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2018-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC236849363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner