Provider Demographics
NPI:1205086717
Name:PYRON, JOSEPH MARTIN (RN, FNP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MARTIN
Last Name:PYRON
Suffix:
Gender:M
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19031 MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-5463
Mailing Address - Country:US
Mailing Address - Phone:661-609-7013
Mailing Address - Fax:
Practice Address - Street 1:38780 TRADE CENTER DR STE 1C
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3641
Practice Address - Country:US
Practice Address - Phone:661-947-5600
Practice Address - Fax:661-947-5900
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607725163W00000X
CA18562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18562OtherNP LICENSE