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General NPI Number Information
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NPI Number | 1851537799
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Entity Type | Individual
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Provider Name | XING PENG YUAN RNSA
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Gender | Male
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Dates
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Enumeration Date | 12/24/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 205 YOAKUM PKWY # 1016
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City | ALEXANDRIA
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State | VA
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Zip | 22304-3800
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Country | US
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Telephone | 703-888-0217
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Fax | 703-286-7514
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Provider Business Mailing Address
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Address Line | 205 YOAKUM PKWY # 1016
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City | ALEXANDRIA
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State | VA
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Zip | 22304-3800
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Country | US
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Telephone | 703-888-0217
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Fax | 703-286-7514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 0001141167
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License Number State | VA
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