Provider Demographics
NPI:1982255261
Name:WEST, JOSHUA BENSON (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:BENSON
Last Name:WEST
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 1:618 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3040
Mailing Address - Country:US
Mailing Address - Phone:940-549-6953
Mailing Address - Fax:
Practice Address - Street 1:618 OAK ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3040
Practice Address - Country:US
Practice Address - Phone:940-549-6953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717322163WG0000X
TXAP143633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice