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NPI Code Detail

MEDICARE: TEXAS JOSHUA MCCUE-GREEN RN

MEDICARE: TEXAS JOSHUA MCCUE-GREEN RN
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
1163W00000XRegistered Nurse95224731CA

General Provider Information

NPI Number : 1073478798
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEXAS JOSHUA MCCUE-GREEN RN
Provider Business Mailing Address
First Line : 2506 MCKINLEYVILLE AVE
Second Line :
City : MCKINLEYVILLE
State : CA
Zip : 95519-3428
Country : US
Telephone Number : 707-826-8633
Fax Number : 707-826-6838
Provider Business Practice Location Address
First Line : 1275 8TH ST
Second Line :
City : ARCATA
State : CA
Zip : 95521-5770
Country : US
Telephone Number : 707-826-8633
Fax Number : 707-826-6838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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