MEDICARE: SOMY XIONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2152503	MN

General Provider Information

NPI Number	:	1336964824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOMY XIONG

Provider Business Mailing Address
First Line	:	6654 WILDFLOWER DR S
Second Line	:
City	:	COTTAGE GROVE
State	:	MN
Zip	:	55016-1727
Country	:	US
Telephone Number	:	651-795-8095
Fax Number	:

Provider Business Practice Location Address
First Line	:	6654 WILDFLOWER DR S
Second Line	:
City	:	COTTAGE GROVE
State	:	MN
Zip	:	55016-1727
Country	:	US
Telephone Number	:	651-795-8095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	12/16/2024

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Directions to “ SOMY XIONG ” Practice Location

Language	Start Address	Practice Location

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