Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R218530 | MD |
N | 363LA2200X | Nurse Practitioner - Adult Health | R218530 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | R218530 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | R218530 | MD |
NPI | 1053814285 |
---|---|
Provider Name | Xin Li |
First Address | Timonium, MD 21093-4014 |
Second Address | Baltimore, MD 21201-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 01/09/2021 |