Healthcare Provider Details

I. General information

NPI: 1720913890
Provider Name (Legal Business Name): JOSHUA MICHAEL ENG RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2784 ALFENA PL
HENDERSON NV
89044-1969
US

IV. Provider business mailing address

2784 ALFENA PL
HENDERSON NV
89044-1969
US

V. Phone/Fax

Practice location:
  • Phone: 760-900-4375
  • Fax:
Mailing address:
  • Phone: 760-900-4375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number900054
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: