Provider Demographics
NPI:1710431085
Name:OAKLEY, TERESA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33100 MARYLAND LINE RD
Mailing Address - Street 2:
Mailing Address - City:MASSEY
Mailing Address - State:MD
Mailing Address - Zip Code:21650-1707
Mailing Address - Country:US
Mailing Address - Phone:302-598-3841
Mailing Address - Fax:
Practice Address - Street 1:33100 MARYLAND LINE RD
Practice Address - Street 2:
Practice Address - City:MASSEY
Practice Address - State:MD
Practice Address - Zip Code:21650-1707
Practice Address - Country:US
Practice Address - Phone:302-598-3841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP151185363LF0000X
FL9313833363LF0000X
CA95091969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily