Provider Demographics
NPI:1083475230
Name:CYPERT, JOSHUA WILLIAM (RN, FNP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:CYPERT
Suffix:
Gender:M
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1223
Mailing Address - Country:US
Mailing Address - Phone:559-308-0655
Mailing Address - Fax:
Practice Address - Street 1:199 W SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-4102
Practice Address - Country:US
Practice Address - Phone:559-225-4706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner