Provider Demographics
NPI:1265105977
Name:PIXTON, JOSHUA L (DNP-PMHNP)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:L
Last Name:PIXTON
Suffix:
Gender:M
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3097 1ST ST
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4521
Mailing Address - Country:US
Mailing Address - Phone:801-803-0615
Mailing Address - Fax:
Practice Address - Street 1:2280 E 25TH ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7542
Practice Address - Country:US
Practice Address - Phone:208-227-2100
Practice Address - Fax:208-227-2362
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID69135363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health