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General NPI Number Information
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NPI Number | 1679774657
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Entity Type | Individual
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Provider Name | JOSHUA SQUIERS NP, PHD, ACNP
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 7190 S CIMARRON RD
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City | LAS VEGAS
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State | NV
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Zip | 89113-2171
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Country | US
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Telephone | 702-675-3240
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Fax | 702-982-6347
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Provider Business Mailing Address
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Address Line | PO BOX 33269
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City | PHOENIX
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State | AZ
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Zip | 85067-3269
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Country | US
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Telephone | 602-406-4786
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Fax | 916-636-4358
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 826047
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License Number State | NV
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