Provider Demographics
NPI:1407892847
Name:LEMIRE, JOSEF HUGH (FNP)
Entity Type:Individual
Prefix:
First Name:JOSEF
Middle Name:HUGH
Last Name:LEMIRE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4349 OLD RAILROAD GRADE RD
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-9721
Mailing Address - Country:US
Mailing Address - Phone:415-407-9501
Mailing Address - Fax:
Practice Address - Street 1:3800 JANES RD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4742
Practice Address - Country:US
Practice Address - Phone:707-826-8264
Practice Address - Fax:707-826-8292
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP6884363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN463551Medicaid
CARN463551Medicaid
CAZZZ32204ZMedicare PIN