Healthcare Provider Details
I. General information
NPI: 1750259628
Provider Name (Legal Business Name): NERVEXA ARIZONA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3135 E LINCOLN DR STE B
PHOENIX AZ
85016-2301
US
IV. Provider business mailing address
3135 E LINCOLN DR STE B
PHOENIX AZ
85016-2301
US
V. Phone/Fax
- Phone: 602-252-3829
- Fax:
- Phone: 602-252-3829
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
W
HUSTEDT
Title or Position: PRESIDENT
Credential: MD
Phone: 602-252-3829