Provider Demographics
NPI:1215030317
Name:EISNER OAKES, MARIE (CRNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:EISNER OAKES
Suffix:
Gender:F
Credentials:CRNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 W. BALTIMORE PIKE
Mailing Address - Street 2:STE 3109
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:484-443-2880
Mailing Address - Fax:484-443-2885
Practice Address - Street 1:1098 W. BALTIMORE PIKE
Practice Address - Street 2:STE 3109
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:484-443-2880
Practice Address - Fax:484-443-2885
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003041G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology