Provider Demographics
NPI:1952643934
Name:THORSTEN, JOSHUA ROY (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:ROY
Last Name:THORSTEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:PAYNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56362-1224
Mailing Address - Country:US
Mailing Address - Phone:320-291-9019
Mailing Address - Fax:
Practice Address - Street 1:321 BELMONT ST
Practice Address - Street 2:
Practice Address - City:PAYNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56362-1224
Practice Address - Country:US
Practice Address - Phone:320-291-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1901616163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse