Provider Demographics
NPI:1033258447
Name:OXLEY, LORI E (CNM)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:E
Last Name:OXLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12800 MISSISSIPPI PKWY STE B200
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6900
Practice Address - Country:US
Practice Address - Phone:219-757-5890
Practice Address - Fax:219-757-5740
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN72000090A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200471720Medicaid
IN200471720Medicaid