=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659725976
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN R OXLEY PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2016
-----------------------------------------------------
Last Update Date | 07/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2935 UNIVERSAL CT STE 2
-----------------------------------------------------
City | OSHKOSH
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54904-6324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-697-8766
-----------------------------------------------------
Fax | 920-416-8581
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1900 SILVER LAKE RD NW STE 110
-----------------------------------------------------
City | NEW BRIGHTON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55112-1789
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-464-6671
-----------------------------------------------------
Fax | 651-628-0411
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA9109562
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | PA9109562
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 4492
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------