Provider Demographics
NPI:1801633987
Name:LI, MICHELLE XIAN (DNP, CRNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:XIAN
Last Name:LI
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MONUMENT RD.
Mailing Address - Street 2:STE 190
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5059
Mailing Address - Country:US
Mailing Address - Phone:717-741-8011
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD.
Practice Address - Street 2:STE 190
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5059
Practice Address - Country:US
Practice Address - Phone:717-741-8011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030083363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner