Healthcare Provider Details

I. General information

NPI: 1982375135
Provider Name (Legal Business Name): JOSHUA ENRIQUE BU FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13395 N MARANA MAIN ST
MARANA AZ
85653-7008
US

IV. Provider business mailing address

PO BOX 188
MARANA AZ
85653-0188
US

V. Phone/Fax

Practice location:
  • Phone: 520-682-4111
  • Fax: 520-616-1442
Mailing address:
  • Phone: 520-682-4111
  • Fax: 520-682-3817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number348534
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: