Individual
XIANWEN QIAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
625 RUSTIC LODGE RD, STE B, INDIANA, PA 15701-3440
(724) 463-3720
(724) 463-6111
Mailing address
160 MILL RUN DR, INDIANA, PA 15701-1532
(724) 349-0670
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP012605
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NUMBER PENDING
—
PA
Enumeration date
01/17/2013
Last updated
01/17/2013
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