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General NPI Number Information
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NPI Number | 1386359859
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Entity Type | Individual
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Provider Name | JOSHUA BLAKE FOSS APRN CNP
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Gender | Male
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 4575 STEPHENS CIR NW
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City | CANTON
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State | OH
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Zip | 44718-3629
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Country | US
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Telephone | 330-499-2986
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 MILES AVE SW
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City | CANTON
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State | OH
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Zip | 44710-1243
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Country | US
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Telephone | 330-962-5970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN.CNP.0033332
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License Number State | OH
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