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General NPI Number Information
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NPI Number | 1902383193
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Entity Type | Organization
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Legal Business Name | OASIS HOME MEDICAL VISITS
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 108 WHITTINGTON DR
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City | INDIANOLA
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State | MS
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Zip | 38751-3434
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Country | US
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Telephone | 662-303-3743
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Fax | 662-445-2532
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Provider Business Mailing Address
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Address Line | 108 WHITTINGTON DR
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City | INDIANOLA
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State | MS
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Zip | 38751-3434
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Country | US
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Telephone | 662-303-3743
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Fax | 662-445-2532
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Authorized Official
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Title or Position | FNP
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Name | KAJUANDRA CHANDLER
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Credential | FNP
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Telephone | 662-445-2531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 901379
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License Number State | MS
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