Provider Demographics
NPI:1902383193
Name:OASIS HOME MEDICAL VISITS
Entity Type:Organization
Organization Name:OASIS HOME MEDICAL VISITS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:KAJUANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-445-2531
Mailing Address - Street 1:108 WHITTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-3434
Mailing Address - Country:US
Mailing Address - Phone:662-303-3743
Mailing Address - Fax:662-445-2532
Practice Address - Street 1:108 WHITTINGTON DR
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-3434
Practice Address - Country:US
Practice Address - Phone:662-303-3743
Practice Address - Fax:662-445-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty