Provider Demographics
NPI:1952994105
Name:YANG-XIONG, PAIA (RM)
Entity Type:Individual
Prefix:
First Name:PAIA
Middle Name:
Last Name:YANG-XIONG
Suffix:
Gender:F
Credentials:RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 N. 124TH ST. #101
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:262-797-9558
Mailing Address - Fax:
Practice Address - Street 1:2505 N. 124TH ST. #101
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1617
Practice Address - Country:US
Practice Address - Phone:262-797-9558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI226279-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse