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NPI Code Detail

MEDICARE: BOBBI JO OLDAKER FNP

MEDICARE: BOBBI JO OLDAKER FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024169068VA

General Provider Information

NPI Number : 1538460837
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBI JO OLDAKER FNP
Provider Business Mailing Address
First Line : 3315 HIGH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23707-3319
Country : US
Telephone Number : 757-399-0759
Fax Number : 757-397-8951
Provider Business Practice Location Address
First Line : 3315 HIGH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23707-3319
Country : US
Telephone Number : 757-399-0759
Fax Number : 757-397-8951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2010
Last Update Date : 11/03/2010

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Directions to “ BOBBI JO OLDAKER FNP” Practice Location

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