Provider Demographics
NPI:1497989339
Name:OXENDINE, SUSAN MARY (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:OXENDINE
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 BRANDON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1127
Mailing Address - Country:US
Mailing Address - Phone:410-321-8651
Mailing Address - Fax:410-245-6346
Practice Address - Street 1:164 BRANDON RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1127
Practice Address - Country:US
Practice Address - Phone:410-321-8651
Practice Address - Fax:410-245-6346
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR049404163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health