Provider Demographics
NPI:1225691736
Name:HOUGHTON, JOEL WILLIAM (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:WILLIAM
Last Name:HOUGHTON
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 N POWER RD APT 1061
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-0004
Mailing Address - Country:US
Mailing Address - Phone:361-688-3692
Mailing Address - Fax:
Practice Address - Street 1:6553 E BAYWOOD AVE STE 209
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-712-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX868612363LF0000X
AZ235375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX868612OtherTEXAS BOARD OF NURSING