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General NPI Number Information
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NPI Number | 1235787037
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Entity Type | Individual
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Provider Name | BREONNA OXENDINE RPH
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1305 N ORANGE AVE STE 120-123
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-2547
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Country | US
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Telephone | 904-284-5677
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Fax |
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Provider Business Mailing Address
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Address Line | 2914 LAUREL SPRINGS DR
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-7270
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Country | US
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Telephone | 386-336-2475
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS59793
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License Number State | FL
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