Provider Demographics
NPI:1063643849
Name:OXENDINE, LESLIE KENDRA (FNP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:KENDRA
Last Name:OXENDINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602458
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2458
Mailing Address - Country:US
Mailing Address - Phone:910-276-6767
Mailing Address - Fax:910-276-7877
Practice Address - Street 1:700A PROGRESS PL
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5545
Practice Address - Country:US
Practice Address - Phone:910-276-6767
Practice Address - Fax:910-276-7877
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004421363LF0000X
NC189147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1063643849Medicaid
NC5004421OtherNC BOARD OF NURSING
SCNP2675Medicaid
NC7005113Medicaid
NC7005113Medicaid
NCNCH044AMedicare PIN
NC2594770AMedicare Oscar/Certification