Basic Information
Provider Information
NPI: 1629524533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OXENDINE
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1923 SULPHUR SPRINGS RD
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378135654
CountryCode: US
TelephoneNumber: 4233179344
FaxNumber: 4237142355
Practice Location
Address1: 1107 N CHARLES G SEIVERS BLVD STE 101
Address2:  
City: CLINTON
State: TN
PostalCode: 377163944
CountryCode: US
TelephoneNumber: 8659346150
FaxNumber: 8653420150
Other Information
ProviderEnumerationDate: 08/31/2016
LastUpdateDate: 02/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X21636TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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