Provider Demographics
NPI:1053041095
Name:OXENREIDER, BROOKE ANNA (FNP-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANNA
Last Name:OXENREIDER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ANNA
Other - Last Name:OXENREIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FLOWERS
Mailing Address - Street 1:165 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-5647
Mailing Address - Country:US
Mailing Address - Phone:770-713-4755
Mailing Address - Fax:
Practice Address - Street 1:1825 GA-34, NEWNAN, GA 30265
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:770-502-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN286377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily