Provider Demographics
NPI:1801810023
Name:OAKLEY, JUDITH F (CRNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:F
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S EUTAW ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1619
Mailing Address - Country:US
Mailing Address - Phone:410-328-9012
Mailing Address - Fax:410-328-9013
Practice Address - Street 1:16 S EUTAW ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1606
Practice Address - Country:US
Practice Address - Phone:410-328-5828
Practice Address - Fax:410-328-9013
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR102241363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA109700800Medicaid
S91454Medicare UPIN
MDF064Medicare PIN