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General NPI Number Information
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NPI Number | 1831070077
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Entity Type | Individual
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Provider Name | JASON LAWRENCE JOSHUA
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Gender | Male
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1492 S MILL AVE STE 212
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City | TEMPE
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State | AZ
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Zip | 85281-5664
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Country | US
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Telephone | 480-410-4128
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Fax |
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Provider Business Mailing Address
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Address Line | 10921 E DIAMOND AVE
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City | MESA
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State | AZ
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Zip | 85208-7627
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 285505
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License Number State | AZ
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