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General NPI Number Information
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NPI Number | 1093273419
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Entity Type | Individual
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Provider Name | LAKOTA CHEYENNE OXENDINE MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1509 JOHN EXUM PKWY
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City | JOHNSON CITY
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State | TN
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Zip | 37604-3826
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Country | US
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Telephone | 423-232-2190
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 RIPSHIN MOUNTAIN RD
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City | ROAN MOUNTAIN
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State | TN
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Zip | 37687-3764
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Country | US
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Telephone | 423-440-4544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2704
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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