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General NPI Number Information
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NPI Number | 1730602459
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Entity Type | Individual
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Provider Name | BRANDI JO MIDDOUR-OXLER DNP, CPNP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 1400 TULLIE RD NE STE 703
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City | ATLANTA
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State | GA
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Zip | 30329-2309
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Country | US
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Telephone | 770-785-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 CHANTILLY DR NE STE 305
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City | ATLANTA
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State | GA
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Zip | 30324-3267
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Country | US
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Telephone | 913-220-3929
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 230100
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 230100
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License Number State | GA
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