Provider Demographics
NPI:1780414888
Name:NELSON, JOSHUA MARK (RN)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MARK
Last Name:NELSON
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 1:12598 NE MUNSON ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-9188
Mailing Address - Country:US
Mailing Address - Phone:928-814-8888
Mailing Address - Fax:
Practice Address - Street 1:12598 NE MUNSON ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9188
Practice Address - Country:US
Practice Address - Phone:928-814-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program