Provider Demographics
NPI:1851959407
Name:OAKES, AUTUMN ENRIQUE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:AUTUMN
Middle Name:ENRIQUE
Last Name:OAKES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E FREESIA CT
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-7999
Mailing Address - Country:US
Mailing Address - Phone:386-801-3718
Mailing Address - Fax:
Practice Address - Street 1:1000 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-2333
Practice Address - Country:US
Practice Address - Phone:386-220-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP11001887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily