Provider Demographics
NPI:1093420051
Name:CORPUZ, JOSHUA SETH (MSN, AGACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:SETH
Last Name:CORPUZ
Suffix:
Gender:M
Credentials:MSN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HIGHLAND AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1783
Mailing Address - Country:US
Mailing Address - Phone:978-741-4133
Mailing Address - Fax:
Practice Address - Street 1:400 HIGHLAND AVE STE 6
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1783
Practice Address - Country:US
Practice Address - Phone:978-741-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2348742163W00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse