National Provider Identifier
Disa Xayavongsone, NP
Disa Xayavongsone, NP is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Jamestown, NY and a listed phone number of (716) 484-4334.
Profile Overview
- NPI
- 1487427886
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- November 07, 2023
- Last Updated
- March 02, 2026
Practice Location
- 107 Institute St
- Jamestown, NY 14701-6628
Phone: (716) 484-4334
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1487427886
- Entity Type
- Individual
- Last Name
- Xayavongsone
- First Name
- Disa
- Credential
- NP
- Mailing Street Address
- 107 Institute St
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-6628
- Mailing Country
- US
- Practice Street Address
- 107 Institute St
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-6628
- Practice Country
- US
- Practice Phone
- (716) 484-4334
- Enumeration Date
- November 07, 2023
- Last Updated
- March 02, 2026
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- March 02, 2026
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X), Registered Nurse (163W00000X)