Provider Demographics
NPI:1326445081
Name:HARROLD, JOSHUA MATTHEW (PNP)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:MATTHEW
Last Name:HARROLD
Suffix:
Gender:M
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:630 S RANCHO DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4849
Mailing Address - Country:US
Mailing Address - Phone:702-998-9505
Mailing Address - Fax:702-527-7939
Practice Address - Street 1:4700 LAS VEGAS BLVD N
Practice Address - Street 2:NELLIS AFB
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89191-6600
Practice Address - Country:US
Practice Address - Phone:702-653-3067
Practice Address - Fax:702-653-3398
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN651182163W00000X
PASP014515363LP0200X
NVAPRN002528363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse