Provider Demographics
NPI:1558137398
Name:FERNANDEZ, JOSEPH E (AGPCNP-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:92 STONE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86351
Mailing Address - Country:US
Mailing Address - Phone:831-262-9193
Mailing Address - Fax:928-282-3910
Practice Address - Street 1:2030 W STATE ROUTE 89A STE B2A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5593
Practice Address - Country:US
Practice Address - Phone:831-262-9193
Practice Address - Fax:928-282-3910
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ300620363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care