Provider Demographics
NPI:1861899601
Name:XIONG, PA HOUA (FNP)
Entity type:Individual
Prefix:
First Name:PA
Middle Name:HOUA
Last Name:XIONG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 NORTH CAROLINA HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075
Mailing Address - Country:US
Mailing Address - Phone:704-455-6420
Mailing Address - Fax:
Practice Address - Street 1:4300 NORTH CAROLINA HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075
Practice Address - Country:US
Practice Address - Phone:704-455-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC210817363L00000X, 363LF0000X
NC5007344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1861899601Medicaid
SCNP3406Medicaid
NCNCM200AMedicare PIN
NCNCM200DMedicare PIN
NCNCM200CMedicare PIN
SCNP3406Medicaid
NCNCM200EMedicare PIN
NCNCM200FMedicare PIN