MEDICARE: CORRINNA OAKLEY PA-C

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
1	363A00000X	Physician Assistant	PA9102027	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA9102027	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952346058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRINNA OAKLEY PA-C

Provider Business Mailing Address
First Line	:	61 MEMORIAL MEDICAL PKWY
Second Line	:	SUITE 2812
City	:	PALM COAST
State	:	FL
Zip	:	32164-5981
Country	:	US
Telephone Number	:	386-586-1860
Fax Number	:	386-586-1861

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY
Second Line	:	SUITE 2812
City	:	PALM COAST
State	:	FL
Zip	:	32164-5981
Country	:	US
Telephone Number	:	386-586-1860
Fax Number	:	386-586-1861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	03/07/2017

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Directions to “ CORRINNA OAKLEY PA-C” Practice Location

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