Provider Demographics
NPI:1003165820
Name:OAKLEY, JAMIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:HUBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:15 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3203
Mailing Address - Country:US
Mailing Address - Phone:508-725-7444
Mailing Address - Fax:
Practice Address - Street 1:350 KINGSTOWN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3244
Practice Address - Country:US
Practice Address - Phone:401-284-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00706363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical