Healthcare Provider Details

I. General information

NPI: 1831507052
Provider Name (Legal Business Name): AARTI KUMAR JOSEPH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W KETTLEMAN LN SUITE 200
LODI CA
95242-4337
US

IV. Provider business mailing address

1901 W KETTLEMAN LN SUITE 200
LODI CA
95242-4337
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-8540
  • Fax: 209-368-2885
Mailing address:
  • Phone: 209-334-8540
  • Fax: 209-368-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: