Healthcare Provider Details

I. General information

NPI: 1467364992
Provider Name (Legal Business Name): XIAOLI XU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 PINE ST
MONTGOMERY AL
36106-1117
US

IV. Provider business mailing address

4278 CAMELLIA DR
MONTGOMERY AL
36109-3005
US

V. Phone/Fax

Practice location:
  • Phone: 334-293-8000
  • Fax:
Mailing address:
  • Phone: 206-825-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-200849
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: