Healthcare Provider Details

I. General information

NPI: 1386106391
Provider Name (Legal Business Name): JOSHUA LEE PRICE F.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 S COEUR D'ALENE LN SUITE C
PAYSON AZ
85541-5662
US

IV. Provider business mailing address

708 S COEUR D'ALENE LN SUITE C
PAYSON AZ
85541-5662
US

V. Phone/Fax

Practice location:
  • Phone: 928-474-9382
  • Fax: 877-673-1780
Mailing address:
  • Phone: 928-474-9382
  • Fax: 877-673-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number226379
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226379
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: