Provider Demographics
NPI:1952482028
Name:JOSLIN, STEPHEN P (NP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:JOSLIN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-0422
Mailing Address - Country:US
Mailing Address - Phone:541-535-9108
Mailing Address - Fax:
Practice Address - Street 1:312 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-9752
Practice Address - Country:US
Practice Address - Phone:541-535-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000032446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500000012OtherRAILROAD MEDICARE
OR023269OtherREGENCE BC
OR172163Medicaid
OR500000012OtherRAILROAD MEDICARE
ORR101918Medicare PIN