Provider Demographics
NPI:1902549991
Name:MOUNT, JOSHUA ALLEN (NP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALLEN
Last Name:MOUNT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5919 N GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:36034-3047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5919 N GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:AL
Practice Address - Zip Code:36034-3047
Practice Address - Country:US
Practice Address - Phone:334-362-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily