Healthcare Provider Details

I. General information

NPI: 1316671878
Provider Name (Legal Business Name): XIAONA LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 TERRA FIRMA DR
MASON OH
45040-8087
US

IV. Provider business mailing address

8051 BIRCHWOOD CT
MASON OH
45040-6904
US

V. Phone/Fax

Practice location:
  • Phone: 513-492-5787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0031404
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: