Healthcare Provider Details

I. General information

NPI: 1700811478
Provider Name (Legal Business Name): CARMEN OXFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N WALNUT AVE STE A
MANSFIELD AR
72944-3522
US

IV. Provider business mailing address

100 N WALNUT AVE STE A
MANSFIELD AR
72944-3522
US

V. Phone/Fax

Practice location:
  • Phone: 479-928-4404
  • Fax:
Mailing address:
  • Phone: 479-928-4404
  • Fax: 479-928-4414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01871
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: