Provider Demographics
NPI:1881620482
Name:TITTLE, JOE F (RN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:F
Last Name:TITTLE
Suffix:
Gender:M
Credentials:RN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 N ZARAGOZA
Mailing Address - Street 2:STE B AND C
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8057
Mailing Address - Country:US
Mailing Address - Phone:915-996-5210
Mailing Address - Fax:915-213-5296
Practice Address - Street 1:1671 N ZARAGOZA RD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8058
Practice Address - Country:US
Practice Address - Phone:915-996-5210
Practice Address - Fax:915-213-5216
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX612956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169982901Medicaid
TX169982904Medicaid
TX169982903Medicaid
TX169982904Medicaid
TX8K2047Medicare PIN
TX169982901Medicaid
TX169982903Medicaid