Healthcare Provider Details

I. General information

NPI: 1053246017
Provider Name (Legal Business Name): JOSH MCMILLEN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 N HUNT HWY
FLORENCE AZ
85132-6937
US

IV. Provider business mailing address

4545 N HUNT HWY
FLORENCE AZ
85132-6937
US

V. Phone/Fax

Practice location:
  • Phone: 520-509-2710
  • Fax:
Mailing address:
  • Phone: 520-509-2710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number345111
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: