Provider Demographics
NPI:1205033727
Name:OXENDINE, JOAN W (A-CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:W
Last Name:OXENDINE
Suffix:
Gender:F
Credentials:A-CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 JERICHO PARK RD
Mailing Address - Street 2:CHRISTA MCAULIFFE RESIDENCE HALL, LL
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3319
Mailing Address - Country:US
Mailing Address - Phone:301-860-4177
Mailing Address - Fax:301-860-4179
Practice Address - Street 1:10205 BALD HILL ROAD
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721
Practice Address - Country:US
Practice Address - Phone:301-860-4177
Practice Address - Fax:301-860-4179
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR062449163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health