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General NPI Number Information
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NPI Number | 1609649987
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Entity Type | Individual
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Provider Name | JOSHUA RASHON PETTY PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 15651 SCOLTY REACH LN
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City | HUMBLE
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State | TX
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Zip | 77346-4919
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Country | US
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Telephone | 229-343-0627
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Fax |
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Provider Business Mailing Address
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Address Line | 15651 SCOLTY REACH LN
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City | HUMBLE
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State | TX
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Zip | 77346-4919
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Country | US
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Telephone | 229-343-0627
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11029482
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 306307
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61501281
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10005209
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1139024
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95028026
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License Number State | CA
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